title: High levels of anxiety and depression in diabetic patients with Charcot foot.
abstract: OBJECTIVE
  Charcot foot is a rare but devastating complication of diabetes. Little research is available on the mental health impact of Charcot foot. Aim of the study is to assess mental health in diabetes patients with Charcot foot and to investigate the moderating effects of socio-demographic factors. The severity of the problem will be statistically evaluated with the help of a reference data set.
  
  
  METHODS
  Cross-sectional questionnaire data using the Hospital Anxiety and Depression Scale (HADS) and demographic background were collected from 50 patients with diabetes and Charcot complications (males 62%; mean age 62.2 ± 8.5 years). Statistical comparisons with a large data set of general diabetes patients acting as a point of reference were carried out.
  
  
  RESULTS
  Anxiety and depression levels were high, (anxiety and depression scores 6.4 ± 4 and 6.3 ± 3.6 respectively). Females reported more severe anxiety and depression. Ethnic minorities and patients out of work reported more severe anxiety. Comparisons with published HADS data indicate that diabetes patients with Charcot foot experience more serious levels of anxiety and depression.
  
  
  CONCLUSIONS
  The high levels of mental health problems which were found in this study in diabetes patients with Charcot foot require recognition by researchers and clinicians. The findings imply the need to screen for mental health problems in diabetes patients with Charcot foot.
authors.affiliation: Department of Foot Health, Mile End Hospital, Barts and London Trust, Bancroft Road, London E1 4DG, UK.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Chapman
authors.affiliation: Community Mental Health Team, Surrey and Borders Partnership Foundation NHS Trust, Randalls Park Drive, Leatherhead KT22 7AD, UK.
authors.forename: Charles Matthew James
authors.initials: CM
authors.lastname: Shuttleworth
authors.affiliation: Centre for Health & Wellbeing Research, University of Northampton, Northampton, UK, now Centre for Health Research, University of Brighton, Falmer, Brighton BN1 9PH, UK.
authors.forename: Jörg Wolfgang
authors.initials: JW
authors.lastname: Huber
keywords: Anxiety; Charcot foot; Depression; Diabetes; Diabetic foot