The psychology of the diabetic patient with chronic ulcer

Introduction: Diabetic leg ulcers occur in at least 15% of patients with diabetes mellitus and are associated with frequent hospitalizations, high cost of care, amputation and death. Purpose: The purpose of the present review was to explore the impact of the psychology of diabetic patients on the development, severity and prognosis of diabetic ulcers, and vice versa, their effect on psychology and quality of life. Material and Method: A review of the literature and search in the international databases (PubMed, Google Scholar, Medscape, Ovid, Cochrane Collaboration, Elsevier, NICE guidelines, Heal. Link) was carried out, with a limitation on publication time (after 2000) and language (Greek and English). According to the criteria, 27 publications were included. Results: There is a positive correlation of depression and other mental disorders with the pathogenic causes of diabetic ulcers, but also with their development (greater severity and frequent relapses). It has also been confirmed that the bi-directional nature of association, as diabetic ulcers affect the psychology and quality of life of patients. Conclusions: Regardless of the causality between psychology and diabetic ulcers, holistic - personalized support from a multidisciplinary team, from diagnosis to diabetes and the provision of appropriate education, improves the prognosis of ulcers, psychology and quality of life of patients and leads reduced amputation and mortality due to disease.

Keywords: Diabetic ulcers, mental disorders, depression, quality of life