Anxiety affects disability and quality of life in patients with painful diabetic neuropathy

作者：Geelen C C^*; Smeets R J E M; Schmitz S; van den Bergh J P; Goossens M E J B; Verbunt J A

来源：European Journal of Pain, 2017, 21(10): 1632-1641.

DOI：10.1002/ejp.1067

BackgroundPainful diabetic neuropathy (PDN) is known to negatively affect psychosocial functioning as expressed by enhanced levels of anxiety and depression. The aim of this study was to specify diabetes and pain-related fears.
MethodsThis questionnaire-based cross-sectional study included 154 patients with PDN (mean age 65.76.6years). Correlation analyses corrected for age, gender, pain intensity, pain duration and insulin treatment were performed to assess the associations of fear of hypoglycaemia (Hypoglycaemia Fear Survey, HFS), kinesiophobia (Tampa Scale of Kinesiophobia, TSK), fear of pain (Pain Anxiety Symptom Scale, PASS-20), fear of falling (Falls Efficacy Scale-I, FES-I), fear of fatigue (Tampa Scale of Fatigue, TSF) and fear of negative evaluation (Brief Fear of Negative Evaluation Scale, BFNE), with quality of life (QoL) (Norfolk Quality of Life Questionnaire, Diabetic Neuropathy Version, QOL-DN) and disability (Pain Disability Index, PDI), respectively.
ResultsIn univariate analyses, all fears were independently associated with QOL-DN and PDI (p<0.001 for all variables). Linear regression models including all fears and confounders, showed that pain intensity, pain duration and FES-I were significantly associated with QOL-DN (R-2=0.603). Pain intensity, male gender and FES-I were significantly associated with PDI (R-2=0.526).
ConclusionsAfter controlling for confounders, levels of pain intensity, duration of pain and fear of falling were negatively associated with QoL in patients with PDN. Pain intensity, male gender and fear of falling were positively associated with disability. Specifying fears enables us to identify potential targets for behavioural interventions that aim to improve psychosocial well-being in patients with PDN.
SignificanceThis study shows that patients with PDN suffer from various fears, which should enable us to design a treatment strategy that directly targets these fears, hereby improving physical and psychosocial well-being in these patients.

• 出版日期2017-11