Advertisement

Social Psychiatry and Psychiatric Epidemiology

, Volume 54, Issue 10, pp 1199–1207 | Cite as

Prevalence of psychological distress, depression and suicidal ideation in an indigenous population in Panamá

  • Rebekah J. Walker
  • Jennifer A. Campbell
  • Aprill Z. Dawson
  • Leonard E. EgedeEmail author
Original Paper

Abstract

Objective

The aim of this study was to investigate the prevalence of serious psychological distress (SPD), depression, and suicidal ideation in an adult Indigenous population in Panamá.

Methods

Data were collected from 211 Kuna adults using a paper-based survey. Depression and suicidal ideation were measured using the Patient Health Questionnaire (PHQ-9), and SPD was measured using the Kessler-6. Univariate analyses were used to describe demographic variables, followed by chi2 tests to compare differences in demographic variables for each of the mental health outcomes (depression, serious psychological distress, suicidal ideation). A regression model, adjusted for all demographic variables, was then run for each mental health outcome to understand independent correlates.

Results

Within the sample surveyed, 6.2% (95% CI 3.4–10.4) reported serious psychological distress, 32.0% (95% CI 25.7–38.9) reported depression, and 22.9% (95% CI 17.4–29.1) reported suicidal ideation. Significant demographic differences existed with 14% of individuals between the age of 60–90 and 17% of individuals with no education reporting SPD. Women were nearly 5 times more likely to report depression than men (OR 4.90, 95% CI 1.27–19.00) and those with higher incomes were less likely to report depression (OR 0.32, 95% CI 0.13–0.78).

Conclusion

High levels of depression, SPD, and suicidal ideation were present in an Indigenous Kuna community in Panamá. Women and individuals with low income were more likely to report depression, and SPD was more common in older individuals and those with low levels of education. Suicidal ideation was high across all demographic factors, suggesting that a community-wide program to address suicide may be warranted.

Keywords

Indigenous Depression Serious psychological distress Suicidal ideation Panamá 

Notes

Acknowledgements

We would like to acknowledge the support and participation of the Ustupu and Ogobsucum communities and the partnership with the Panama Ministry of Health that made this study possible.

Author contributions

LEE obtained funding for the study, coordinated data collection, conducted statistical analyses, contributed to drafting the article and revised the article critically for important intellectual content. RJW and JAC participated in data collection and contributed to drafting the article and revised the article critically for important intellectual content. AZD drafted the manuscript and revised the article critically for important intellectual content. All authors were involved in conception and design and approved the final manuscript.

Funding

This study was supported by Indigenous Health International (IHI), an approved 501(c)(3) non-profit organization in the United States. No financial disclosures are reported by the authors of this paper.

Compliance with ethical standards

Conflicts of interests

The authors declare that they have no competing interests.

Ethics approval

The current research protocol, research procedures, and study related documentation was approved by the Western Institutional Review Board (WIRB). The WIRB, is an accredited organization that has been providing human subjects and regulatory compliance for more than 40 years across 70 countries.

Consent for publication

Consent for publication was obtained from leaders of both study communities.

Availability of data and material

The dataset generated and analyzed during the current study is not available because of confidentiality agreement with the study communities.

References

  1. 1.
    Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, Charlson FJ, Norman RE, Flaxman AD, Johns N, Burstein R, Murray CJ, Vos T (2013) Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010. Lancet 382(9904):1575–1586CrossRefGoogle Scholar
  2. 2.
    Global burden of disease (GBD) (2017) Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global burden of disease study 2016. Lancet 390(10100):1211–1259CrossRefGoogle Scholar
  3. 3.
    Global burden of disease (GBD) (2015) Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the global burden of disease study 2013. Lancet 386(9995):743–800CrossRefGoogle Scholar
  4. 4.
    World Health Organization (2014) Preventing suicide: a global imperative. Available at: https://www.who.int/mental_health/suicide-prevention/world_report_2014/en/. Accessed 3 May 2019
  5. 5.
    Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T (2016) Global burden of mental, neurological, and substance use disorders: an analysis from the global burden of disease study 2010. In: Patel V, Chisholm D, Dua T, Laxminarayan R, Medina-Mora ME (eds) Mental, neurological, and substance use disorders: disease control priorities, third edition, vol 4. The World Bank, Washington (DC). 2016 March 14CrossRefGoogle Scholar
  6. 6.
    Lund C, De Silva M, Plagerson S, Cooper S, Chisholm D, Das J, Knapp M, Patel V (2011) Poverty and mental disorders: breaking the cycle in low-income and middle-income countries. Lancet 378(9801):1502–1514CrossRefGoogle Scholar
  7. 7.
    Gracey M, King M (2009) Indigenous health part 1: determinants and disease patterns. Lancet 374:65–75CrossRefGoogle Scholar
  8. 8.
    King M, Smith A, Gracey M (2009) Indigenous health part 2: the underlying causes of the health gap. Lancet 374:76–85CrossRefGoogle Scholar
  9. 9.
    Kaholokula JK, Antonio MC, Ing CK, Hermosura A, Hall KE, Knight R, Wills TA (2017) The effects of perceived racism on psychological distress mediated by venting and disengagement coping in Native Hawaiians. BMC Psychol 5(1):2CrossRefGoogle Scholar
  10. 10.
    Kisely S, Alichniewicz KK, Black EB, Siskind D, Spurling G, Toombs M (2017) The prevalence of depression and anxiety disorders in Indigenous people of the Americas: a systematic review and meta-analysis. J Psychiatr Res 84:137–152CrossRefGoogle Scholar
  11. 11.
    Benoit AC, Cotnam J, Raboud J, Greene S, Beaver K, Zoccole A, O’Brien-Teengs D, Balfour L, Wu W, Loutfy M (2016) Experiences of chronic stress and mental health concerns among urban Indigenous women. Arch Womens Ment Health 19(5):809–823CrossRefGoogle Scholar
  12. 12.
    Cunningham J, Paradies YC (2012) Socio-demographic factors and psychological distress in Indigenous and non-Indigenous Australian adults aged 18–64 years: analysis of national survey data. BMC Public Health 12:95CrossRefGoogle Scholar
  13. 13.
    Hinton R, Kavanagh DJ, Barclay L, Chenhall R, Nagel T (2015) Developing a best practice pathway to support improvements in Indigenous Australians’ mental health and well-being: a qualitative study. BMJ Open 5(8):e007938CrossRefGoogle Scholar
  14. 14.
    Jorm AF, Bourchier SJ, Cvetkovski S, Stewart G (2012) Mental health of Indigenous Australians: a review of findings from community surveys. Med J Aust 196:118–121CrossRefGoogle Scholar
  15. 15.
    Black E, Kisely S, Alichniewicz K, Toombs M (2017) Mood and anxiety disorders in Australia and New Zealand’s Indigenous populations: a systematic review and meta-analysis. Psychiatry Res 255:128–138CrossRefGoogle Scholar
  16. 16.
    Steel Z, Marnane C, Iranpour C, Chey T, Jackson JW, Patel V, Silove D (2014) The global prevalence of common mental disorders: a systematic review and meta-analysis 1980–2013. Int J Epidemiol 43(2):476–493CrossRefGoogle Scholar
  17. 17.
    Montenegro RA, Stephens C (2006) Indigenous health in Latin America and the Caribbean. Lancet 367:1859–1869CrossRefGoogle Scholar
  18. 18.
    Silva MT, Caicedo Roa M, Martins SS, da Silva ATC, Galvao TF (2017) Prevalence and correlates of depressive symptoms among adults living in the Amazon, Brazil: a population-based study. J Affect Disord 222:162–168CrossRefGoogle Scholar
  19. 19.
    Yusim A, Anbarasan D, Hall B, Goetz R, Neugebauer R, Stewart T, Abou J, Castaneda R, Ruiz P (2010) Sociocultural domains of depression among Indigenous populations in Latin America. Int Rev Psychiatry 22(4):370–377CrossRefGoogle Scholar
  20. 20.
    Azuero AJ, Arreaza-Kaufman D, Coriat J, Tassinari S, Faria A, Castaneda-Cardona C, Rosselli D (2017) Suicide in the Indigenous population of Latin America: a systematic review. Rev Colomb Psiquiatr 46(4):237–242CrossRefGoogle Scholar
  21. 21.
    Clifford AC, Doran CM, Tsey K (2013) A systematic review of suicide prevention interventions targeting Indigenous peoples in Australia, United States, Canada and New Zealand. BMC Public Health 13:463CrossRefGoogle Scholar
  22. 22.
    Araujo M, Moraga C, Chapman E, Barreto J, Illanes E (2016) Interventions to improve access to health services by Indigenous peoples in the Americas. Rev Panam Salud Publica 40(5):371–381PubMedGoogle Scholar
  23. 23.
    Nasir BF, Hides L, Kisely S, Ranmuthugala G, Nicholson GC, Black E, Gill N, Kondalsamy-Chennakesavan S, Toombs M (2016) The need for a culturally-tailored gatekeeper training intervention program in preventing suicide among Indigenous peoples: a systematic review. BMC Psychiatry 16(1):357CrossRefGoogle Scholar
  24. 24.
    Janevic MR, Aruquipa Yujra AC, Marinec N, Aguilar J, Aikens JE, Tarrazona R, Piette JD (2016) Feasibility of an interactive voice response system for monitoring depressive symptoms in a lower-middle income Latin American country. Int J Ment Health Syst 10:59CrossRefGoogle Scholar
  25. 25.
    Montenegro RA, Stephens C (2006) Indigenous health in Latin America and the Caribbean. The Lancet 367:1859–1869CrossRefGoogle Scholar
  26. 26.
    Aguilar R, Garcia-Huidobro G (2001) Panama: indigenous peoples. Socio economic and demographic characteristics key social policy issues to alleviate their poverty. Santiago–Gothenburg, January 2001Google Scholar
  27. 27.
    Howe J (1998) A people who would not kneel: Panamá, the united states, and the san blas kuna. Smithsonian Series of Ethnographic Inquiry. Smithsonian Institution Press, WashingtonGoogle Scholar
  28. 28.
    Meditz S, Hanratty D (1989) Area handbook series: Panama: a country study. Library of Congress, 4th edn. Federal Research Division, WashingtonGoogle Scholar
  29. 29.
    McDonald A, Motta J, Roa R, Batista I, Correa R, González B. (2011) Prevalencia de factores de riesgo asociados a enfermedad cardiovascular en la población adulta de 18 años y más. Provincias de Panamá y Colón. Ministerio de Salud—Panama. Accessed from: https://cspcocle.files.wordpress.com/2011/11/prevalencia-de-factores-de-riesgos-asociados-a-enfermedad-cardiovascular.pdf. Accessed 3 May 2019
  30. 30.
    Schantz K, Reighard C, Aikens JE, Aruquipa A, Pinto B, Valverde H, Piette JD (2017) Screening for depression in Andean Latin America: factor structure and reliability of the CES-D short form and the PHQ-8 among Bolivian public hospital patients. Int J Psychiatry Med 52(4–6):315–327CrossRefGoogle Scholar
  31. 31.
    Bougie E, Arim RG, Kohen DE, Findlay LC (2016) Validation of the 10-item Kessler psychological distress scale (K10) in the 2012 aboriginal peoples survey. Health Rep 27(1):3–10PubMedGoogle Scholar
  32. 32.
    Kroenke K, Spitzer RL, Williams JBW (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16:606–613CrossRefGoogle Scholar
  33. 33.
    Arrieta J, Aguerrebere M, Raviola G et al (2017) Validity and utility of the patient health questionnaire (PHQ)-2 and PHQ-9 for screening and diagnosis of depression in rural chiapas, Mexico: a cross-sectional study. J Clin Psychol 73(9):1076–1090CrossRefGoogle Scholar
  34. 34.
    Zhong Q, Gelaye B, Fann JR et al (2014) Cross-cultural validity of the Spanish version of PHQ-9 among pregnant Peruvian women: a rasch item response theory analysis. J Affect Dis 158:148–153CrossRefGoogle Scholar
  35. 35.
    Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand SLT, Walters EE, Zaslavsky AM (2002) Short screening scales to monitor population prevalence and trends in non-specific psychological distress. Psychol Med 32:959–976CrossRefGoogle Scholar
  36. 36.
    Cohen RA, Zammitti EP (2016) Access to care among adults aged 18–64 with serious psychological distress: early release of estimates from the National Health Interview Survey, 2012—September 2015. National Center for Health Statistics. Center for Disease Control and Prevention, AtlantaGoogle Scholar
  37. 37.
    Kessler RC, Green JG, Bruber MJ et al (2010) Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative. Int J Methods Psychiatr Res 19(Supplement 1):4–22CrossRefGoogle Scholar
  38. 38.
    Louzon SA, Bossarte R, McCarthy JF, Katz IR (2016) Does suicidal ideation as measured by the PHQ-9 predict suicide among VA patients? Psychiatr Serv 67(5):517–522CrossRefGoogle Scholar
  39. 39.
    World Health Organization (2013) Mental health action plan: 2013–2020. Geneva, Switzerland. Available at: http://www.who.int/mental_health/publications/action_plan/en/. Accessed 3 May 2019

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of General Internal Medicine, Department of MedicineMedical College of WisconsinMilwaukeeUSA
  2. 2.Center for Advancing Population ScienceMilwaukeeUSA

Personalised recommendations