AIMS/HYPOTHESIS: The aim of the study was to determine whether diabetic peripheral neuropathy (DPN) is a risk factor for depressive symptoms and examine the potential mechanisms for this relationship. METHODS: This longitudinal study (9 and 18 month follow-up) of 338 DPN patients (mean age 61 years; 71% male; 73% type 2 diabetes) examined the temporal relationships between DPN severity (mean +/- SD; neuropathy disability score [NDS], 7.4 +/- 2.2; mean vibration perception threshold, 41.5 +/- 9.5 V), DPN somatic experiences (symptoms and foot ulceration), DPN psychosocial consequences (restrictions in activities of daily living [ADL] and social self-perception) and the Hospital Anxiety and Depression subscale measuring depressive symptoms (HADS-D; mean 4.9 +/- 3.7). RESULTS: Controlling for baseline HADS-D and demographic/disease variables, NDS at baseline significantly predicted increased HADS-D over 18 months. This association was mediated by baseline unsteadiness, which was significantly associated with increased HADS-D. Baseline ADL restrictions significantly predicted increased HADS-D and partly mediated the association between baseline unsteadiness and change in HADS-D. Increased pain, unsteadiness and ADL restrictions from baseline to 9 months each significantly predicted increased HADS-D over 18 months. Change in social self-perception from baseline to 9 months significantly predicted increased HADS-D and partly mediated the relationships of change in unsteadiness and ADL restrictions with change in HADS-D. CONCLUSIONS/ INTERPRETATION: These results confirm that neuropathy is a risk factor for depressive symptoms because it generates pain and unsteadiness. Unsteadiness is the symptom with the strongest association with depression, and is linked to depressive symptoms by perceptions of diminished self-worth as a result of inability to perform social roles.
AIMS/HYPOTHESIS: The aim of the study was to determine whether diabetic peripheral neuropathy (DPN) is a risk factor for depressive symptoms and examine the potential mechanisms for this relationship. METHODS: This longitudinal study (9 and 18 month follow-up) of 338 DPNpatients (mean age 61 years; 71% male; 73% type 2 diabetes) examined the temporal relationships between DPN severity (mean +/- SD; neuropathy disability score [NDS], 7.4 +/- 2.2; mean vibration perception threshold, 41.5 +/- 9.5 V), DPN somatic experiences (symptoms and foot ulceration), DPN psychosocial consequences (restrictions in activities of daily living [ADL] and social self-perception) and the Hospital Anxiety and Depression subscale measuring depressive symptoms (HADS-D; mean 4.9 +/- 3.7). RESULTS: Controlling for baseline HADS-D and demographic/disease variables, NDS at baseline significantly predicted increased HADS-D over 18 months. This association was mediated by baseline unsteadiness, which was significantly associated with increased HADS-D. Baseline ADL restrictions significantly predicted increased HADS-D and partly mediated the association between baseline unsteadiness and change in HADS-D. Increased pain, unsteadiness and ADL restrictions from baseline to 9 months each significantly predicted increased HADS-D over 18 months. Change in social self-perception from baseline to 9 months significantly predicted increased HADS-D and partly mediated the relationships of change in unsteadiness and ADL restrictions with change in HADS-D. CONCLUSIONS/ INTERPRETATION: These results confirm that neuropathy is a risk factor for depressive symptoms because it generates pain and unsteadiness. Unsteadiness is the symptom with the strongest association with depression, and is linked to depressive symptoms by perceptions of diminished self-worth as a result of inability to perform social roles.
Authors: Caroline A Abbott; Adam P Garrow; Anne L Carrington; Julie Morris; Ernest R Van Ross; Andrew J Boulton Journal: Diabetes Care Date: 2005-08 Impact factor: 19.112
Authors: G E Reiber; L Vileikyte; E J Boyko; M del Aguila; D G Smith; L A Lavery; A J Boulton Journal: Diabetes Care Date: 1999-01 Impact factor: 19.112
Authors: Michael Von Korff; Wayne Katon; Elizabeth H B Lin; Gregory Simon; Evette Ludman; Malia Oliver; Paul Ciechanowski; Carolyn Rutter; Terry Bush Journal: Psychosom Med Date: 2005 Mar-Apr Impact factor: 4.312
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Authors: Ryan T Crews; Biing-Jiun Shen; Laura Campbell; Peter J Lamont; Andrew J M Boulton; Mark Peyrot; Robert S Kirsner; Loretta Vileikyte Journal: Diabetes Care Date: 2016-06-06 Impact factor: 19.112
Authors: Lisa H Williams; Carolyn M Rutter; Wayne J Katon; Gayle E Reiber; Paul Ciechanowski; Susan R Heckbert; Elizabeth H B Lin; Evette J Ludman; Malia M Oliver; Bessie A Young; Michael Von Korff Journal: Am J Med Date: 2010-08 Impact factor: 4.965
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Authors: Ryan T Crews; Kristin L Schneider; Sai V Yalla; Neil D Reeves; Loretta Vileikyte Journal: Diabetes Metab Res Rev Date: 2016-06-10 Impact factor: 4.876