The incidence of depression in patients with diabetic foot ulcers: a systematic review and meta-analysis.
Abstract
Some patients with diabetic foot ulcers (DFUs) may suffer from depression, but the latest information regarding the incidence of depression in patients with DFUs is limited. This review aimed to provide up-to-date information concerning the incidence of depression in patients with DFUs. We searched the literature in PubMed and Web of Science databases, limited to English publications. 11 eligible studies with a total of 2117 participants were included in this review. A random-effects model was applied due to high heterogeneity. The incidence of depression in patients with DFUs ranged from 26% (95% confidence interval [CI] = 19% to 33%) to 85% (95% CI = 78% to 92%), and was 47% (95% CI = 36% to 58%) after systematically summarizing. Subgroup analyses suggested that the incidence of depression were 49% (95%CI = 35% to 63%) in Europe, 37% (95% CI = 23% to 51%) in Asia, 62% (95% CI = 48% to 76%) in North America. Additionally, the incidence of depression were 40% (95% CI = 29% to 50%) in prospective studies, 55% (95% CI = 28% to 82%) in retrospective studies, 40% (95% CI = 29% to 50%) in cross-sectional studies. Furthermore, the incidence of depression were 43% (95% CI = 25% to 60%), 49% (95% CI = 35% to 63%), 68% (95% CI = 35% to 102%), 32% (95% CI = 26% to 38%), and 28% (95% CI = 18% to 38%) in patients with DFUs assessed by the Hospital Anxiety and Depression Scale, EuroQol 5-Dimension Questionnaire, Geriatric Depression Scale, Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and the Center for Epidemiologic Studies Depression Scale, respectively. The estimates were robust in the sensitivity analysis. According to the meta-regression analyses, diabetes mellitus duration ( t = 0.93, P = .422), publication years ( t = −0.72, P = .488), and age of subjects ( t = 0.01, P = .989) were not the sources of high heterogeneity. Our meta-analysis showed nearly half of patients with DFUs had depression problems.
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In a prospective study of 478 patients, patients who received a referral for revascularization within 56 days had improved rate of wound healing compared with those with longer time to revascularization (HR, 1.96; 95% CI, 1.52-2.52; P < .001).
“A prospective study of 478 patients identified an improved rate of wound healing among patients undergoing revascularization with shorter time to healing among those who received a referral for revascularization within 56 days compared with those who had a longer time to revascularization (hazard ratio [HR], 1.96; 95% CI, 1.52-2.52;P < .001[absolute rates not provided]).78,81”
From Diabetic Foot Ulcers (2023) · cites this paper as [81]
In patients with chronic limb-threatening ischemia who require revascularization for tissue healing, delayed revascularization is associated with slower healing.
“In patients with chronic limb-threatening ischemia who require revascularization for tissue healing, delayed revascularization is associated with slower healing.”
From Diabetic Foot Ulcers (2023) · cites this paper as [81]
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- Authors
- Jiang, F.-H., Liu, X.-M., Yu, H.-R., Qian, Y., & Chen, H.-L.
- Affiliations
- Nantong University (CN)
- Affiliated Hospital of Nantong University, Nantong City, Jiangsu Province, People’s Republic of China
- Affiliated Hospital of Nantong University (CN)
- Corresponding author
- Chen, Hong-Lin
- Venue
- The International Journal of Lower Extremity Wounds
- Publisher
- SAGE Publications
- Published
- 2020-06-11
- Volume
- 21
- Issue
- 2
- Pages
- 161-173
- ISSN
- 1534-7346 (ISSN-L)
- 1552-6941
- OpenAlex
- W3034956338
- Cited by
- 65
- References
- 41
- Citations by year
- 2026: 8 · 2025: 16 · 2024: 12 · 2023: 19 · 2022: 7 · 2021: 2 · 2020: 1
- FWCI
- 1.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The International Journal of Lower Extremity Wounds (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Dermatology › Skin Diseases and Diabetes
- Keywords
- diabetic foot ulcer, depression, depression incidence, diabetes mellitus, diabetes duration, depression screening
- MeSH terms
- Aged, Cross-Sectional Studies, Depression, Diabetes Mellitus, Humans, Prospective Studies, Retrospective Studies, Incidence, Diabetic Foot
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