Background: Depression and anxiety can potentially influence treatment results of diabetic
Objective: Of our study was to explore: (1) prevalence of these disorders in patients with diabetic
foot ulcers (DFU); (2) possible risk factors of depression and anxiety; (3) possible links between ulcer
treatment results and depression/anxiety status.
Methods: 285 outpatients with diabetes and foot or leg ulcers were tested for depression and anxiety
with self-report scales: CES-D and the anxiety subscale from HADS. Ulcer treatment results, incidence
of new ulcers and number of hospital admissions were assessed after 1.5 years of follow-up.
Results: Depression was detected in 110 patients (39%), anxiety in 103 (36%). Females had depression
and anxiety more often than males (48% and 46% vs. 27% and 25% respectively). A combined
score based on diabetes duration, insulin treatment, history of myocardial infarction, history of foot
ulcers and recent foot surgery was higher in patients with than without depression (3.0 vs. 2.0,
p=0.02). Every of these or other potential risk factors alone was not associated with depression or
anxiety. Patients with depression did not demonstrate poorer prognosis except higher mortality in
subgroup of severely depressed patients without ulcer history. For anxiety we got similar results as
its presence strongly correlated with depression.
Conclusion: The overall prevalence of depression and anxiety in DFU patients is compatible with
other diabetic populations. Various parameters of ulcer severity and duration did not influence the
probability of depression and anxiety occurrence. Depression in general was not associated with
poorer ulcer treatment results.