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Risk factors for depression and anxiety in painful and painless diabetic polyneuropathy: A multicentre observational cross-sectional study

D. Kec, A. Rajdova, J. Raputova, B. Adamova, I. Srotova, EK. Nekvapilova, RN. Michalcakova, M. Horakova, J. Belobradkova, J. Olsovsky, P. Weber, G. Hajas, M. Kaiserova, R. Mazanec, V. Potockova, E. Ehler, M. Forgac, F. Birklein, N. Üçeyler, C....

. 2022 ; 26 (2) : 370-389. [pub] 20211010

Language English Country Great Britain

Document type Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc22011136

BACKGROUND: Despite the high prevalence of depression and anxiety in chronic pain conditions, current knowledge concerning emotional distress among painful diabetic polyneuropathy (pDSPN) and other diabetes mellitus (DM) sufferers is limited. METHODS: This observational multicentre cohort study employed the Hospital Anxiety and Depression Scale, the Beck Depression Inventory II and the State-Trait Anxiety Inventory to assess symptoms of depression and anxiety in several groups with diabetes, as well as in a control group. The study cohort included 347 pDSPN patients aged 63.4 years (median), 55.9% males; 311 pain-free diabetic polyneuropathy (nDSPN) patients aged 63.7 years, 57.9% males; 50 diabetes mellitus (DM) patients without polyneuropathy aged 61.5 years, 44.0% males; and 71 healthy controls (HC) aged 63.0 years, 42.3% males. The roles played in emotional distress were explored in terms of the biological, the clinical (diabetes-, neuropathy- and pain-related), the socio-economic and the cognitive factors (catastrophizing). RESULTS: The study disclosed a significantly higher prevalence of the symptoms of depression and anxiety not only in pDSPN (46.7% and 60.7%, respectively), but also in patients with nDSPN (24.4% and 44.4%) and DM without polyneuropathy (22.0% and 30.0%) compared with HCs (7.0% and 14.1%, p < 0.001). Multiple regression analysis demonstrated the severity of pain and neuropathy, catastrophic thinking, type 2 DM, lower age and female sex as independent contributors to depression and anxiety. CONCLUSIONS: In addition to the severity of neuropathic pain and its cognitive processing, the severity of diabetic polyneuropathy and demographic factors are key independent contributors to emotional distress in diabetic individuals. SIGNIFICANCE: In large cohorts of well-defined painless and painful diabetic polyneuropathy patients and diabetic subjects without polyneuropathy, we found a high prevalence of the symptoms of depression and anxiety, mainly in painful individuals. We have confirmed neuropathic pain, its severity and cognitive processing (pain catastrophizing) as dominant risk factors for depression and anxiety. Furthermore, some demographic factors (lower age, female sex), type 2 diabetes mellitus and severity of diabetic polyneuropathy were newly identified as important contributors to emotional distress independent of pain.

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$a Risk factors for depression and anxiety in painful and painless diabetic polyneuropathy: A multicentre observational cross-sectional study / $c D. Kec, A. Rajdova, J. Raputova, B. Adamova, I. Srotova, EK. Nekvapilova, RN. Michalcakova, M. Horakova, J. Belobradkova, J. Olsovsky, P. Weber, G. Hajas, M. Kaiserova, R. Mazanec, V. Potockova, E. Ehler, M. Forgac, F. Birklein, N. Üçeyler, C. Sommer, J. Bednarik, E. Vlckova
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$a BACKGROUND: Despite the high prevalence of depression and anxiety in chronic pain conditions, current knowledge concerning emotional distress among painful diabetic polyneuropathy (pDSPN) and other diabetes mellitus (DM) sufferers is limited. METHODS: This observational multicentre cohort study employed the Hospital Anxiety and Depression Scale, the Beck Depression Inventory II and the S $a BACKGROUND Despite the high prevalence of depression and anxiety in chronic pain conditions current knowledge concerning emotional distress among painful diabetic polyneuropathy pDSPN and other diabetes mellitus DM sufferers is limited METHODS This observational multicentre cohort study employed the Hospital Anxiety and Depression Scale the Beck Depression Inventory II and the State Trai $a BACKGROUND: Despite the high prevalence of depression and anxiety in chronic pain conditions, current knowledge concerning emotional distress among painful diabetic polyneuropathy (pDSPN) and other diabetes mellitus (DM) sufferers is limited. METHODS: This observational multicentre cohort study employed the Hospital Anxiety and Depression Scale, the Beck Depression Inventory II and the State-Trait Anxiety Inventory to assess symptoms of depression and anxiety in several groups with diabetes, as well as in a control group. The study cohort included 347 pDSPN patients aged 63.4 years (median), 55.9% males; 311 pain-free diabetic polyneuropathy (nDSPN) patients aged 63.7 years, 57.9% males; 50 diabetes mellitus (DM) patients without polyneuropathy aged 61.5 years, 44.0% males; and 71 healthy controls (HC) aged 63.0 years, 42.3% males. The roles played in emotional distress were explored in terms of the biological, the clinical (diabetes-, neuropathy- and pain-related), the socio-economic and the cognitive factors (catastrophizing). RESULTS: The study disclosed a significantly higher prevalence of the symptoms of depression and anxiety not only in pDSPN (46.7% and 60.7%, respectively), but also in patients with nDSPN (24.4% and 44.4%) and DM without polyneuropathy (22.0% and 30.0%) compared with HCs (7.0% and 14.1%, p < 0.001). Multiple regression analysis demonstrated the severity of pain and neuropathy, catastrophic thinking, type 2 DM, lower age and female sex as independent contributors to depression and anxiety. CONCLUSIONS: In addition to the severity of neuropathic pain and its cognitive processing, the severity of diabetic polyneuropathy and demographic factors are key independent contributors to emotional distress in diabetic individuals. SIGNIFICANCE: In large cohorts of well-defined painless and painful diabetic polyneuropathy patients and diabetic subjects without polyneuropathy, we found a high prevalence of the symptoms of depression and anxiety, mainly in painful individuals. We have confirmed neuropathic pain, its severity and cognitive processing (pain catastrophizing) as dominant risk factors for depression and anxiety. Furthermore, some demographic factors (lower age, female sex), type 2 diabetes mellitus and severity of diabetic polyneuropathy were newly identified as important contributors to emotional distress independent of pain.
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$a Raputova, Jana $u Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czech Republic $u Faculty of Medicine, Masaryk University, Brno, Czech Republic $u Central European Institute of Technology, Masaryk University, Brno, Czech Republic
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$a Adamova, Blanka $u Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czech Republic $u Faculty of Medicine, Masaryk University, Brno, Czech Republic $u Central European Institute of Technology, Masaryk University, Brno, Czech Republic $1 https://orcid.org/0000000180352687
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$a Srotova, Iva $u Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czech Republic $u Faculty of Medicine, Masaryk University, Brno, Czech Republic $u Central European Institute of Technology, Masaryk University, Brno, Czech Republic $1 https://orcid.org/0000000339124927 $7 xx0231590
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$a Horakova, Magda $u Department of Neurology, Center for Neuromuscular Diseases (Associated National Center in the European Reference Network ERN EURO-NMD), University Hospital Brno, Brno, Czech Republic $u Faculty of Medicine, Masaryk University, Brno, Czech Republic $1 https://orcid.org/0000000333172661
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$a Belobradkova, Jana $u Diabetology Centre, Department of Internal Medicine and Gastroenterology, University Hospital Brno, Brno, Czech Republic
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$a Olsovsky, Jindrich $u Diabetology Centre, St. Anne University Hospital, Brno, Czech Republic
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$a Weber, Pavel $u Department of Internal Medicine, Geriatrics and Practical Medicine, University Hospital Brno, Brno, Czech Republic
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$a Birklein, Frank $u Department of Neurology, University Medical Center, Mainz, Germany
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