Anxiety, depression and sleep disorders in patients with diabetic neuropathic pain: a systematic review

ABSTRACT

Introduction: Diabetic neuropathic pain (DNP) is a disabling complication suffered by patients with diabetic neuropathy. DNP coexists with different conditions, especially mental and sleep disorders, which seem to impair the management and course of the disease. However, there is a lack of accurate results about their prevalence. Consequently, the authors analyze the prevalence of anxiety, depression and/or sleep disorders in DND patients.

Areas covered: Among the 206 articles found in the search, 8 studies with data from 5 different countries fulfilled the inclusion criteria. The prevalence of anxiety reported ranged between 7.8%-60.4% and that of depression between 13.6%- 50.6%. The two conditions coexist in 26.4%-30.6% in DND patients. A higher prevalence was found when the information was obtained using scales than when it came from medical records. The prevalence of sleep disorders found ranged from 41.6%-43.8%. However, there is lack of information about and the results are often expressed using the mean scores of the scales.

Expert opinion: Although the data in the literature vary, a high prevalence of anxiety, depression and sleep comorbidities exists among patients with DNP. These results reaffirm the need to perform systematic evaluations and to identity their presence using validated instruments to obtain more reliable results.

KEYWORDS:

• Diabetic neuropathies
• pain
• comorbidity
• depression
• anxiety
• sleep disorders

Article highlights

• Diabetic neuropathic pain (DNP) coexists with different conditions, especially mental and sleep disorders, which seem to impair the management and course of the disease. However, the results are inaccurate

• The objective of this review is to analyze the prevalence of anxiety and/or depression and/or sleep disorders in patients with DNP.

• A search was performed of the PubMed and SCOPUS databases where the search criteria were the original studies published in english and spanish involving patients with type 1 or type 2 diabetes with DNP, and that also included the comorbidities mentioned above, using MeSH terms.

• Among the 206 articles found in the search, 8 studies with data from 5 different countries fulfilled the inclusion criteria.

• The prevalence of anxiety reported ranged between 7.8%-60.4% and that of depression between 13.6%- 50.6%. The two conditions coexist in 26.4%-30.6% of DNP patients.

• The prevalence of sleep disorders ranged from 41.6%-43.8%. However, there is lack of information about and the results are often expressed using the mean scores of the scales.

• A higher prevalence was found when the information was obtained using scales than when it came from medical records.

• Although the data in the studies in the literature vary, a high prevalence of this comorbidities exists among patients with DNP.

Declaration of interest

C Naranjo has disclosed that she has received a grant for researching in the field of Pain from “Sociedad Andaluza de Medicina Familiar y Comunitaria (SAMFyC). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or conflict with the subject matter or materials discussed in this manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was supported by the External Chair of Pain, a collaboration between the University of Cádiz and the Grünenthal Foundation. The Grünenthal Foundation is a private non-profit making organization that promotes the dissemination of scientific knowledge and supports research.