Study design Cross-sectional study.Objectives To provide data on the rates of sexual dysfunction (SD) among the Greek spinal cord injury (SCI) women and to investigate any association with demographic and clinical variables. Setting Greek territory. Methods Our sample was enrolled from rehabilitation institutes throughout Greece and included 30 women with SCI living in the community for at least 1 year after the primary inpatient rehabilitation program. They were assessed for SD using the Female Sexual Function Index (FSFI). Pearson's test was performed to examine the correlation of SD with clinicaldemographic parameters as defined by specific questionnaires: Satisfaction With Life Scale (SWLS), World Health Organization Quality of Life-BREF (WHOQOL-BREF), Spinal Cord Independence Measure (SCIM), Patient Health Questionnaire (PHQ-9), Craig Handicap Assessment and Reporting Technique (CHART).Results SD was revealed in 63.3% of the study participants. The mean FSFI score was 14.4. Pearson's analysis showed that age was negatively correlated with FSFI scores (p = 0.006), while pain had a negative impact only on desire scores (p = 0.04). FSFI scores were negatively correlated with PHQ-9 (p = 0.04), while there was a positive correlation with SWLS (p = 0.003), SCIM (p = 0.013), and specific domains of WHOQOL-BREF (psychological, relations, environment), and CHART (mobility, social integration). Conclusions The rate of SD (63.3%) generally agrees with the findings of high rates in most of the literature, although it is rather lower, in comparison to other populations. Old age and depressive symptoms were the major identified determinants of SD.

Diabetic neuropathy is a common complication of diabetes, occurring in 25-50% of patients, with pain partaking in the clinical picture of about half of the patients. At the same time, there are many studies confirming the high prevalence of mental disorders in diabetes patients, and recent research signifies the bidirectional relationship that seems to exist. In this review, we examined the existing literature regarding the role of anxiety and depression in diabetic neuropathy. Methods: Utilizing PubMed as our search engine, we performed a search of the existing literature of the last decade. The key-words used were "depression" "anxiety" "pain" and "diabetic neuropathy". This search led us to 189 results, and out of those 13 were found to correlate with our criteria and were used in this paper. Results: From the analysis of the existing literature we cite studies concluding that people with depression are more susceptible to the development of diabetes. Moreover, anxiety and depression are correlated with complications and higher prevalence of painful neuropathy. In diabetic patients, symptoms of anxiety and depression are independently connected with more pain. At a pathophysiology level, disorders in the cellular function of the CNS, such as central sensitization and changes in neuroglia, are noticed both in neuropathic pain and depression. Conclusions: This review highlights the connection between pain and depression in patients with diabetic neuropathy, with emphasis on the effect of anxiety and depression in neuropathic pain. With the association with the pathophysiological pathways and the clinical phenotype further researched, new goals in the prevention and the treatment of pain in diabetic neuropathy can be studied.