Screening for Depressive Symptoms in Patients with Diabetic Foot using (CES-D) Scale: A Cross-Sectional Study

Mervat alsous, Feras Elhajji, Ghada Abu Amara, Eman Elayeh, Amal Akour, Ayman Mismar


Aim: The aim of this study was to assess levels of depressive symptoms present in patients with diabetic foot.
Methods: A convenience sampling method was used to recruit 108 patients with diabetic foot. After having completed the Centre for Epidemiologic Studies Depression Scale CES-D scale, the patients' demographic data and medical history were collected using pre-structured forms.
Results: Of the entire sample, 38.9% have CES-D score ≥27, which indicates risk of major depression. Logistic regression analysis showed that retinopathy was significantly associated with increased depressive symptoms among diabetic foot patients (odds ratio 3.41(p=0.017)). Taking supplement therapy and not taking a combination of oral hypoglycemic agent and insulin treatment were significantly associated with higher depressive symptoms (odds ratio 3.38 (p=0.022), 2.83 (p=0.030)), respectively. Patients with primary education level have the highest odds ratio among all factors associated with risk of major depression (OR, 4.07; p=0.003).
Conclusions: The risk of major deression among patients with diabetic foot in Jordan is high compared to general diabetic population. This was associated with low educational level, retinopathy, taking supplemt therapy, but not taking a combination of oral hypoglycemic agent and insulin. There is a need for routine screening for depressive symptoms in patients with diabetic foot to help in the prevention, early detection of depression and even referral to a psychiatrist.


CES-D, depression , Diabetic foot

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