How Do Depression and Distress Affect Surgical Outcomes in Diabetic Amputation?
© 2024 HMP Global. All Rights Reserved.
Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Podiatry Today or HMP Global, their employees, and affiliates.
A poster presented at the recent American Society of Podiatric Surgeons (ASPS) Annual Surgical Conference finds that diabetes-related extremity amputation depression and distress (DREADD) is a complication following amputation and surgeons should screen for depression.1
The study included 20 patients who underwent partial or total toe amputations or partial ray resections, excluding traumatic amputations.1 The authors noted 18 patients had increased Patient Health Questionnaire-9 (PHQ-9) scores within 30 days post-amputation, increasing from 3.65 to 12.35. PHQ-9 scores above 10 indicate at least moderate depressive symptoms, according to the study.
Depression is bidirectionally linked to type 2 diabetes, increasing the risk of foot ulcers, mortality, and major non-traumatic amputation, as well as post-amputation depression when diagnosed preoperatively, notes the study.1 Researchers added that depressive symptoms in patients with type 2 diabetes may impair ulcer healing and adherence to treatment.
“Our qualitative results suggest non-traumatic amputations can be emotionally traumatic, with some patients fearing major amputation more than death,” note the authors.1 They coined the acronym DREADD to describe the phenomenon.
Researchers advocated surgeons screen patients with type 2 diabetes for depressive symptoms before and after non-traumatic amputations, referring them to mental health specialists as needed.1 The study notes potential for developing a new psychiatric/mental health subspecialty to address the psychological impacts of diabetes such as DREADD.
Reference
1. Brooks BM, Brooks BM, Arp AS, et al. Diabetes-Related Extremity Amputation Depression & Distress (DREADD). Presented at the American Society of Podiatric Surgeons Annual Surgical Conference, Oct. 18–19, 2024, New Orleans, LA.
Photo courtesy of Collin Pehde, DPM
