Psychosocial, psychiatric, and clinical implications of diabetic foot ulceration: A prospective analysis

Abstract Background: Foot ulceration is very common complication of diabetes. Prevalence of psychiatric disorders is considered to be more in patients suffering from diabetic foot ulcers. Aim: The present study was carried out to observe and evaluate the various psychiatric disorders experienced by patients with diabetic foot ulceration, management of these disorders, and the metabolic abnormalities associated with the use of antipsychotic drugs. Materials and Methods: In this observational study, 293 patients in the age group of 25-70 years of either sex, who visited this hospital for the management of diabetic foot ulcers, were included after taking informed consent. They were prospectively followed for a period of 24 months. A phenomenological approach using semi-structured, conversational interviews was used. They were interviewed for the type of diabetes, duration of diabetes and duration of foot ulcer and other complications, type of treatment for diabetes and diabetic foot, psychosocial effects of foot ulceration on their daily The Hamilton rating scale for depression, questionnaire was used for assessing depression while the Hamilton anxiety rating scale questionnaire was used to rate the severity of anxiety. The data collected and analyzed for the type of psychiatric disorder, treatment options, type of drugs given and any side effects or complications occur as a result of these drugs. Descriptive statistical methods were used to analyze the data. Conclusion: Diabetic foot ulcer is associated with an increased incidence of various psychiatric disorders, depression being the most common among these. Drugs used to treat depression and associated with metabolic disturbances. Hyperglycemia associated with the use of antidepressants and antipsychotics further worsens the foot ulceration. Coordination between different specialties is important to manage the clinical, biological, and psychosocial aspects of this critical illness.