title: Prevalence and Prognostic Value of Depression and Anxiety in Patients with Diabetic Foot Ulcers and Possibilities of their Treatment.
abstract: BACKGROUND
  Depression and anxiety can potentially influence treatment results of diabetic complications.
  
  
  OBJECTIVE
  Of our study was to explore: (1) prevalence of these disorders in patients with diabetic foot ulcers (DFU); (2) possible risk factors of depression and anxiety; (3) possible links between ulcer treatment results and depression/anxiety status.
  
  
  METHODS
  285 outpatients with diabetes and foot or leg ulcers were tested for depression and anxiety with self-report scales: CES-D and the anxiety subscale from HADS. Ulcer treatment results, incidence of new ulcers and number of hospital admissions were assessed after 1.5 years of follow-up.
  
  
  RESULTS
  Depression was detected in 110 patients (39%), anxiety in 103 (36%). Females had depression and anxiety more often than males (48% and 46% vs. 27% and 25% respectively). A combined score based on diabetes duration, insulin treatment, history of myocardial infarction, history of foot ulcers and recent foot surgery was higher in patients with than without depression (3.0 vs. 2.0, p=0.02). Every of these or other potential risk factors alone was not associated with depression or anxiety. Patients with depression did not demonstrate poorer prognosis except higher mortality in subgroup of severely depressed patients without ulcer history. For anxiety we got similar results as its presence strongly correlated with depression.
  
  
  CONCLUSIONS
  The overall prevalence of depression and anxiety in DFU patients is compatible with other diabetic populations. Various parameters of ulcer severity and duration did not influence the probability of depression and anxiety occurrence. Depression in general was not associated with poorer ulcer treatment results.
authors.affiliation: Diabetologist of the Diabetic Foot outpatient clinic, Outpatient Center #22, Moscow, Russia.
authors.forename: Oleg V
authors.initials: OV
authors.lastname: Udovichenko
authors.forename: N V
authors.initials: NV
authors.lastname: Maximova
authors.forename: M V
authors.initials: MV
authors.lastname: Amosova
authors.forename: O A
authors.initials: OA
authors.lastname: Yunilaynen
authors.forename: E A
authors.initials: EA
authors.lastname: Berseneva
authors.forename: E G
authors.initials: EG
authors.lastname: Starostina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001007:Anxiety / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology*; D017719:Diabetic Foot / Q000401:mortality / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012426:Russia; D057566:Self Report; D012720:Severity of Illness Index; D014945:Wound Healing
keywords: Diabetes mellitus; amputation; anxiety; depression; diabetic foot ulcer; mortality; prognosis; risk factors