Depression and Diabetic Neuropathy: A Complex Relationship

Geringer, Edith S.; Perlmuter, Lawrence C.; Stern, Theodore A.; Nathan, David M.

doi:10.1177/089198878800100103

Cited by 39 publications

(17 citation statements)

References 24 publications

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“…The results of the MANOVA indicated there were significant differences among For the majority of symptom severities (items [1][2][3][4][5][6][7][8][9][10][11][13][14][15][16][17][18][19], the pattern was similar to the symptom prevalence observations. Patients with depression reported more severe symptoms than the group with diabetes only, and depressed patients with and without diabetes reported similar levels of symptom severity ( Figure 3).…”

Section: -15 16-23 Total Bdi Scoresupporting

confidence: 68%

“…There is evidence that depression in diabetes can be diagnosed with reasonable sensitivity despite the potential under-diagnosis of depression (and other psychiatric conditions) associated with this diagnostic rule (1). This finding provides some methodologic support to observations that major depression is significantly more common in patients with diabetes than in the general US population (2)(3)(4)(5)(6)(7)(8)(9)(10)(11).…”

Section: Introductionsupporting

confidence: 54%

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Similarity of depression in diabetic and psychiatric patients.

Lustman

Freedland²,

Carney³

et al. 1992

Psychosomatic Medicine

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Diabetic and psychiatric out-patients were studied to determine whether the symptom profile of depression was similar in medically ill and medically well subjects. The diagnosis of major depression was determined using psychiatric interviews and DSM-IIIR criteria. The 21-item Beck Depression Inventory (BDI) was used to characterize the prevalence and severity of depression symptoms, and the measure was divided into cognitive (13 symptoms) and somatic (eight symptoms) subsets. Seventeen (81%) of 21 symptoms (including 12/13 cognitive and 5/8 somatic symptoms) were not statistically different in prevalence or severity between the depressed diabetic patients (N = 41) and the depressed psychiatric patients (N = 68). Both of these depressed groups were significantly different from a nondepressed diabetic comparison group (N = 58) in the prevalence and severity of every BDI symptom except weight loss. These data show that the symptom profile of depression in diabetic patients (in particular the cognitive symptoms) is similar to that in depressed psychiatric patients and is readily differentiated from the symptom profile in nondepressed diabetic patients. Our observations support the diagnostic validity of the DSM-IIIR criteria for major depression in this medically-ill outpatient sample.

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Section: -15 16-23 Total Bdi Scoresupporting

confidence: 68%

Section: Introductionsupporting

confidence: 54%

Similarity of depression in diabetic and psychiatric patients.

Lustman

Freedland²,

Carney³

et al. 1992

Psychosomatic Medicine

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“…In this study, neuropathy and negative attitude toward feet predicted development of a first ulcer. These data may reflect the complex relationship between depression and neuropathy [18,20].…”

Section: Consequences Of Foot Complications In Diabetic Patientsmentioning

confidence: 92%

“…This study of 14 patients and 11 caregivers reported that reduction in social activities, increased family tensions, lost time from work, and negative effects on general health were experienced by both groups. The enormous impact of lack of mobility in everyday living for both the patient with ulceration and for his or her caregivers led Brod [20] to refer to the condition as "the burden of a non-weight-bearing" regimen. This may explain some of the reasons for the counterintuitive findings that ulceration may affect quality of life more than amputation does: those fitted with prostheses are encouraged to be mobile, whereas those with an ulcer are not.…”

Section: Consequences Of Foot Complications In Diabetic Patientsmentioning

confidence: 98%

The Diabetic Foot: Quality of Life

Price

2004

Clinical Infectious Diseases

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A literature search investigated the health-related quality of life of patients with foot complications associated with diabetes. There are very few data on the life experiences of patients with infection and diabetic foot ulceration. The potential consequence of infection, in terms of amputation, is the focus of some studies, in which immobility and a restricted social life are potential areas of concern, although the location of the amputation may confound these results. The health-related quality of life for patients with diabetic foot ulceration may be poorer than that experienced by those who had amputation, because many of the patients live with the fear of recurrence of ulceration, repeated bouts of infection, and potential life-long disability. The clinical and academic communities must work together to improve the data on this important outcome measure so that we can work with patients to improve preventive care and treatment options.

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“…Evidence from individual studies [7][8][9][10], supported by a meta-analysis [11], suggests that there is a link between DPN and depressive symptoms. However, previous studies have focused almost exclusively on severe neuropathic pain, even though less than a third of patients with DPN experience painful symptoms [12] and many experience no symptoms [13].…”

Section: Introductionmentioning

confidence: 99%

Predictors of depressive symptoms in persons with diabetic peripheral neuropathy: a longitudinal study

et al. 2009

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Aims/hypothesis The aim of the study was to determine whether diabetic peripheral neuropathy (DPN) is a risk factor for depressive symptoms and examine the potential mechanisms for this relationship. Methods This longitudinal study (9 and 18 month followup) of 338 DPN patients (mean age 61 years; 71% male; 73% type 2 diabetes) examined the temporal relationships between DPN severity (mean±SD; neuropathy disability score [NDS], 7.4±2.2; mean vibration perception threshold, 41.5±9.5 V), DPN somatic experiences (symptoms and foot ulceration), DPN psychosocial consequences (restrictions in activities of daily living [ADL] and social selfperception) and the Hospital Anxiety and Depression subscale measuring depressive symptoms (HADS-D; mean 4.9±3.7).Results Controlling for baseline HADS-D and demographic/disease variables, NDS at baseline significantly predicted increased HADS-D over 18 months. This association was mediated by baseline unsteadiness, which was significantly associated with increased HADS-D. Baseline ADL restrictions significantly predicted increased HADS-D and partly mediated the association between baseline unsteadiness and change in HADS-D. Increased pain, unsteadiness and ADL restrictions from baseline to 9 months each significantly predicted increased HADS-D over 18 months. Change in social self-perception from baseline to 9 months significantly predicted increased HADS-D and partly mediated the relationships of change in unsteadiness and ADL restrictions with change in HADS-D. Conclusions/interpretation These results confirm that neuropathy is a risk factor for depressive symptoms because it

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Depression and Diabetic Neuropathy: A Complex Relationship

Cited by 39 publications

References 24 publications

Similarity of depression in diabetic and psychiatric patients.

Similarity of depression in diabetic and psychiatric patients.

The Diabetic Foot: Quality of Life

Predictors of depressive symptoms in persons with diabetic peripheral neuropathy: a longitudinal study

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