4.5 Article

Pain severity in diabetic peripheral neuropathy is associated with patient functioning, symptom levels of anxiety and depression, and sleep

期刊

JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
卷 30, 期 4, 页码 374-385

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.jpainsymman.2005.04.009

关键词

painful diabetic peripheral neuropathy; pain severity; sleep impairment; symptoms levels; anxiety; depression

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Our goal was to evaluate pain severity, pain-related interference with function, steep impairment, symptom levels of anxiety and. depression, and quality of life among patients with painful diabetic peripheral neuropathy (DPN). Participants in a burden of illness survey (n =255) completed the modified Brief Pain Inventory-DPN (BPI-DPN), MOS Steep Scale., Hospital Anxiety and Depression Scale (HADS), Short Form Health Survey-12v2 (SF-12v2), and the EuroQoL (EQ-5D). Patients were 61 +/- 12.8 years old (51.4 % female), had diabetes for 12 +/- 10.3 years and painful DPN,for 6.4 +/- 6.4 years. Average and Worst Pain scores (BPI-DPN, 0-10 scales) were 5.0 +/- 2.5 and 5.6 +/- 2.8. Pain substantially interfered (>= 4 on 0-10 scales) with walking ability, normal work, sleep, enjoyment of life, mood, and general activity. Moderate to severe symptom levels of anxiety and depression (HADS-A and HADS-D scores >= 11 on 0-21 scales) occurred in 35 % and 28 % of patients, respectively. Patients reported greater sleep problems compared with the general U.S. population and significant impairment in both physical and mental functioning (SF- 12v2) compared with subjects with diabetes. The mean EQ-5D utility score was 0.5 +/- 0.3. Greater pain levels in DPN (mild to moderate to severe) corresponded with higher symptom levels of anxiety and depression, more steep problems, and lower utility ratings and physical and mental functioning, (all Ps <0.01). Painful DPN is associated with decrements in many aspects of patients' lives: physical and emotional functioning, affective symptoms, and sleep problems. The negative impact is higher inpatients with greater pain severity.

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