Chen JQ, Chen ZH, Zheng WB, Shen XQ. Correlation of anxiety and depression with pain in patients with diabetic foot ulcers and analysis of risk factors. World J Psychiatry 2025; 15(6): 105334 [DOI: 10.5498/wjp.v15.i6.105334]
Corresponding Author of This Article
Xiang-Qian Shen, PhD, Doctor, Department of Plastic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 1367 Wenyi West Road, Yuhang District, Hangzhou 310003, Zhejiang Province, China. shenxiangqian@sina.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jiang-Qiang Chen, Zu-Hui Chen, Wei-Bin Zheng, Department of Plastic Surgery, Tiantai County People’s Hospital, Taizhou 317200, Zhejiang Province, China
Xiang-Qian Shen, Department of Plastic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Chen JQ designed the study, collected and analyzed the data, and wrote the manuscript; Chen JQ, Chen ZH, and Zheng WB participated in the study conception and data collection; Chen JQ and Shen XQ contributed to the study design and provided guidance; All authors read and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Tiantai County People’s Hospital.
Informed consent statement: Patients were not required to provide informed consent for the study, because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiang-Qian Shen, PhD, Doctor, Department of Plastic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 1367 Wenyi West Road, Yuhang District, Hangzhou 310003, Zhejiang Province, China. shenxiangqian@sina.com
Received: February 18, 2025 Revised: March 24, 2025 Accepted: April 27, 2025 Published online: June 19, 2025 Processing time: 100 Days and 1.2 Hours
Abstract
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.
Core Tip: Studies on the correlation between anxiety, depression, and pain in diabetic foot ulcers (DFUs) and analysis of contributing risk factors are limited. This study addresses this gap by providing valuable clinical insights. The findings demonstrate a significant positive correlation between anxiety, depression, and pain in patients with DFUs, highlighting the importance of timely and effective pain management in mitigating these negative emotional states. Furthermore, younger age (< 50 years), higher Wagner’s grade, and high visual analog scale scores were identified as key risk factors for anxiety and depression. Targeted psychological support and proactive interventions for patients exhibiting these characteristics, such as age < 50 years, advanced Wagner’s grades, or high pain levels, can effectively minimize their susceptibility to anxiety and depression.
