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



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.


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.


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).


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.


Indigenous Depression Serious psychological distress Suicidal ideation Panamá 



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.


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.


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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

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