Chen Jiang-Qiang, Chen Zu-Hui, Zheng Wei-Bin, Shen Xiang-Qian
Department of Plastic Surgery, Tiantai County People's Hospital, Taizhou 317200, Zhejiang Province, China.
Department of Plastic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
World J Psychiatry. 2025 Jun 19;15(6):105334. doi: 10.5498/wjp.v15.i6.105334.
BACKGROUND: Pain often predisposes patients with diabetic foot ulcers (DFUs) to negative emotional states, such as anxiety and depression, which can significantly impair treatment outcomes and recovery. However, very few studies have explored the relationship between anxiety, depression, and pain in DFUs, as well as the associated risk factors. AIM: To analyze the correlation between anxiety, depression, and pain in patients with DFUs and to identify the associated risk factors. METHODS: This study included 106 patients diagnosed with DFUs who were admitted to Tiantai County People's Hospital between March 2022 and March 2024. The patients' anxiety levels were evaluated using Zung's self-rating anxiety scale (SAS), depression status was assessed using Zung's self-rating depression scale (SDS), and pain intensity was assessed using the visual analog scale (VAS). Subsequently, correlations between SAS, SDS, and VAS scores were analyzed. Univariate and multivariate analyses were conducted to explore the risk factors that contributed to anxiety and depression in patients with DFUs. RESULTS: Among the 106 patients, 39.62% exhibited anxiety and 43.40% presented with depression. Most patients experiencing anxiety or depression exhibited mild symptoms, with no severe cases observed. Compared with asymptomatic patients, those with anxiety or depression had significantly higher VAS scores. Correlation analysis indicated a significant positive relationship between both SAS and SDS scores and the VAS score. Univariate analysis identified sex, age, Wagner's grade, presence of other complications, and smoking history as factors significantly associated with anxiety and depression. Multivariate analysis further confirmed that younger age, higher Wagner's grade, and higher VAS scores were independent predictors of anxiety and depression. CONCLUSION: This study reveals a significant positive correlation between anxiety, depression, and pain in patients with DFUs. This finding suggests that timely and effective pain intervention may be beneficial in alleviating negative emotions such as anxiety and depression. In addition, younger age (< 50 years), higher Wagner's grade, and higher VAS scores increase the risk of developing anxiety and depression in this patient population.
背景：疼痛常使糖尿病足溃疡（DFU）患者易出现焦虑和抑郁等负面情绪状态，这会显著损害治疗效果和康复情况。然而，极少有研究探讨DFU患者中焦虑、抑郁与疼痛之间的关系以及相关危险因素。 目的：分析DFU患者焦虑、抑郁与疼痛之间的相关性，并确定相关危险因素。 方法：本研究纳入了2022年3月至2024年3月间入住天台县人民医院的106例确诊为DFU的患者。使用zung自评焦虑量表（SAS）评估患者的焦虑水平，使用zung自评抑郁量表（SDS）评估抑郁状态，使用视觉模拟量表（VAS）评估疼痛强度。随后，分析SAS、SDS和VAS评分之间的相关性。进行单因素和多因素分析以探讨导致DFU患者焦虑和抑郁的危险因素。 结果：106例患者中，39.62%表现出焦虑，43.40%表现出抑郁。大多数有焦虑或抑郁的患者症状较轻，未观察到严重病例。与无症状患者相比，有焦虑或抑郁的患者VAS评分显著更高。相关性分析表明，SAS和SDS评分与VAS评分均呈显著正相关。单因素分析确定性别、年龄、瓦格纳分级、是否存在其他并发症以及吸烟史是与焦虑和抑郁显著相关的因素。多因素分析进一步证实，年龄较小、瓦格纳分级较高和VAS评分较高是焦虑和抑郁的独立预测因素。 结论：本研究揭示了DFU患者焦虑、抑郁与疼痛之间存在显著正相关。这一发现表明，及时有效的疼痛干预可能有助于减轻焦虑和抑郁等负面情绪。此外，年龄较小（<50岁）、瓦格纳分级较高和VAS评分较高会增加该患者群体发生焦虑和抑郁的风险。
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