Depression and anxiety level of patients with diabetic foot and associated factors

ABSTRACT DEPRESSION AND ANXIETY LEVEL OF PATIENTS WITH DIABETIC FOOT AND ASSOCIATED FACTORS Introduction and Aims Diabetic foot infections are leading health problems of the modern world's because of its rapidly increasing prevalence, major amputation and mortality rates. It is known that the depression and anxiety frequency increases in chronic diseases with loss of function like diabetic foot. Therefore, it is very important for chronic patients to be evaluated in terms of mental, spiritual and psychosocial aspects. The aim of this study is to determine depression and anxiety level and related factors in diabetic foot patients. Methods Patients were included in the study, who admitted to the Adnan Menderes University Research and Practice Hospital Chronic Wound and Infection Care Unit with a diabetic foot infection between March 1 and August 31, 2017. The 'Hospital Anxiety-Depression Scale' and the sociodemographic and medical history data form was administered by face-to-face interview method and also patient-centered clinical interviews were conducted to establish diagnostic verification and treatment plan. The ethics of the study was taken with the decision of the Adnan Menderes University Faculty of Medicine Non-Interventional Research Ethics Committee dated 09.03.2017 and numbered 6. Statistical analysis was performed in SPSS 16.0 program. Results Sixty-five patients with 47 males (72.3%) were included in the study and the mean age±SD was 60.28±10.62. The number of patients have already diagnosed with depression-anxiety was 20 (30.8%); the number of patients receiving treatment was 9 (13.8%). As a result of the patient interviews, 26 (40.0%) patients have depression and/or anxiety currently. The factors, increasing the level of depression and anxiety, were presence of severe pain (p:0,002),near-term major amputation (p:0,036), immobilization (p:0,000), depression-anxiety history (p:0,001), inpatient treatment (p:0,006), presence of nephropathy (p:0,016), neurological comorbidity (p:0,018) and the number of chronic diseases (p:0,015). Depression and/or anxiety was 5,5 times more likely for inpatient treatment, about 9 times for both of depression-anxiety history and immobilization, and 17 times for severe pain. Conclusions The overall diagnoses of the patients in our study was close to 50%; but it is seen that the rate of receiving treatment for these patients, which are evaluated by many physicians beforehand, is very low. According to our study; effective palliation of pain, early mobilization and outpatient treathment may be protective against depression and anxiety. Especially in patients with depression and/or anxiety history, we think that, in addition to the existing treatments, all the diabetic foot patients should be evaluated psychologically and the appropriate treatments will increase the treatment success and the survival. Keywords: diabetic foot, depression, anxiety, HADS