Predicting the Quality of Life in Patients With Painful Diabetic Neuropathy (PDN) Based on Pain Severity, Pain Catastrophizing, Pain Acceptance, Depression, Anxiety, and Sleep Disturbance: Assessing the Prevalence of Psychiatric Symptoms in Iranian Patients With PDN.

Abstract

Background: This study aimed to predict the quality of life in patients with Painful Diabetic Neuropathy (PDN) based on pain severity, pain catastrophizing, pain acceptance, depression, anxiety, and sleep disturbance. Also, assessing the prevalence of psychiatric symptoms in Iranian patients with PDN.Method: In this descriptive correlational study, 1500 MTBI patients admitted to the diabetes centers in Tehran, Iran, from November 2019, to August 2020 were selected using the convenient sampling method. One thousand one hundred twenty patients (mean age, 53.6± 12.6 years) participated in the research. Data were collected using the Quality of life (NeuroQol) questionnaire (as a dependent variable); Beck Depression Inventory, Beck Anxiety Inventory, 10-cm visual analog scale (pain severity), Pain Catastrophizing Scale (PCS), Chronic Pain Acceptance Questionnaire (CPAQ) and Pittsburgh Sleep Quality Index (PSQI). Finally, the data were analyzed in SPSS‑26 by multiple regression analysis.Results: The study results showed that the regression model was significant (P < 0.5), in which variables predicted 42% of total changes in the quality of life in patients. Predicting factors from the most significant to the lowest include depression, pain catastrophizing, pain acceptance, pain severity, sleep disturbance, and finally, anxiety. Also, in patients with PDN, the prevalence rates of sleep disturbances, depression, and anxiety are 85.5%, 68.2%, and 62.1%, respectively. Also, comorbid depression and anxiety were found in 47% of patients.Conclusion: The findings of this study show a considerable relationship between these factors and quality of life. Thus, it is suggested to design more specific psychological‑based rehabilitation programs concerning these variables to improve these patients' quality of life, focusing on stronger variables (depression and pain catastrophizing) for reaching better treatment outcomes. Furthermore, according to the findings of this research, which shows a high level of anxiety, depression, and sleep disturbance in Iranian patients with PDN, all experts and clinicians must focus on these psychiatric symptoms to reduce disease problems.