title: Diabetic peripheral neuropathic pain is a stronger predictor of depression than other diabetic complications and comorbidities.
abstract: To investigate the independent effect on depression of painless diabetic polyneuropathy, painful diabetic polyneuropathy, and general and diabetes-related comorbidities.
  
  
  
  In 181 patients, the presence of painless diabetic polyneuropathy, painful diabetic polyneuropathy, comorbidities and depression was assessed using the Michigan Neuropathy Screening Instrument Questionnaire, the Michigan Diabetic Neuropathy Score, nerve conduction studies, the Douleur Neuropathique en 4 Questions, the Charlson Comorbidity Index and the Beck Depression Inventory-II.
  
  
  
  In all, 46 patients met the criteria of confirmed painless diabetic polyneuropathy and 25 of painful diabetic polyneuropathy. Beck Depression Inventory-II scores indicative of mild-moderate-severe depression were reached in 36 patients (19.7%). In a multiple logistic regression analysis (including age, sex, body mass index, being unemployed, duration, haemoglobin A1c, insulin treatment, systolic blood pressure, nephropathy, retinopathy, Charlson Comorbidity Index and painful diabetic polyneuropathy), female sex (odds ratio: 5.9, p = 0.005) and painful diabetic polyneuropathy (odds ratio: 4.6, p = 0.038) were the only independent predictors of depression. Multiple regression analysis, including Douleur Neuropathique en 4 Questions and Michigan Diabetic Neuropathy Score instead of painful diabetic polyneuropathy, showed that Douleur Neuropathique en 4 Questions, in addition to female sex, was a significant predictor of depressive symptoms severity (p =0.005).
  
  
  
  Painful diabetic polyneuropathy is a greater determinant of depression than other diabetes-related complications and comorbidities. Painful symptoms enhance depression severity more than objective insensitivity.
authors.affiliation: Endocrinology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: D'Amato
authors.affiliation: Endocrinology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Morganti
authors.affiliation: Endocrinology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Greco
authors.affiliation: Endocrinology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Di Gennaro
authors.affiliation: Endocrinology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Cacciotti
authors.affiliation: Endocrinology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Longo
authors.affiliation: Neurology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Mataluni
authors.affiliation: Endocrinology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Lauro
authors.affiliation: Neurology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Girolama A
authors.initials: GA
authors.lastname: Marfia
authors.affiliation: Endocrinology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy vispa@mclink.it.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Spallone
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D003929:Diabetic Neuropathies / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Charlson Comorbidity Index; Neuropathic pain; comorbidities; depression; diabetic neuropathy