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New Meta-Analysis Reveals High Incidence Of Depression Among Patients With DFUs

In a recently published systematic review and meta-analysis, Jiang and colleagues have provided important work into the incidence of depression in patients with diabetic foot ulcers (DFUs).1 After reviewing 11 eligible studies and a total of 2,117 total participants, the researchers found the overall incidence of depression in patients with DFUs to be 47 percent. 

Interestingly, a subgroup analysis revealed a 49 percent incidence of depression in European patients with DFUs, 37 percent in Asian patients with DFUs and 62 percent in North Americans with DFUs.1 Which test or scale that study researchers assessed for depression did cause the incidence of identified depression to vary significantly but the duration of diabetes, the year of publication and patient age did not.

Diabetic foot ulcers can significantly alter someone’s activity. As podiatrists, we see this on a daily basis. What we need to do better is to act on it. 

We have tried really hard at the Southwestern Academic Limb Salvage Alliance (SALSA) at the University of Southern California to engage our behavioral health team as much as possible. We have found that our occupational therapy colleagues at our unit are particularly adept at working up and working with these patients to get them the help they need. 

Although our focus is on the lower extremity, the healing of DFUs does not occur in a vacuum. It is my hope that studies like this one make us more acutely aware of the struggles our patients face and allow us to take action to bridge the gap in addressing these issues.

Dr. Armstrong is Professor of Surgery at the Keck School of Medicine at the University of Southern California. He is the Director of the Southwestern Academic Limb Salvage Alliance (SALSA). 

Editor’s Note: This blog originally appeared at: . It is adapted with permission from the author.


1. Jiang F-H, Liu X-M, Yu H-R, Qian Y, Chen H-L. The incidence of depression in patient with diabetic foot ulcers: a systematic review and meta-analysis. Int J Low Extrem Wounds. 2020. doi: 10.1177/1534734620929892.

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