Psychosocial Factors in Painful Diabetic Neuropathy: A Systematic Review of Treatment Trials and Survey Studies

Author:

Kioskli Kitty1,Scott Whitney12,Winkley Kirsty3,Kylakos Stavros4,McCracken Lance M125

Affiliation:

1. Health Psychology Section, Psychology Department, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK

2. Guy’s and St Thomas’ NHS Foundation Trust, London, UK

3. Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK

4. Department of Computer Science, City, University of London, London, UK

5. Department of Psychology, Uppsala University, Uppsala, Sweden

Abstract

Abstract Objective Diabetes mellitus is associated with a number of complications that can adversely impact patients’ quality of life. A common and often painful complication is painful diabetic neuropathy. The aims of this study were to systematically review and summarize evidence from studies of psychological treatments and psychosocial factors related to painful diabetic neuropathy and assess the methodological quality of these studies. Methods Electronic databases, related reviews, and associated reference lists were searched. Summaries of participants’ data relating to the efficacy of psychological treatments and/or to associations between psychosocial factors and outcomes in painful diabetic neuropathy were extracted from the included studies. The methodological quality of included studies was assessed using two standardized quality assessment tools. Results From 2,921 potentially relevant titles identified, 27 studies were included in this systematic review. The evidence suggests that depression, anxiety, sleep, and quality of life are the most studied variables in relation to pain outcomes in painful diabetic neuropathy and are consistently associated with pain intensity. The magnitude of the associations ranged from small to large. Conclusions Research into psychosocial factors in painful diabetic neuropathy is unexpectedly limited. The available evidence is inconsistent and leaves a number of questions unanswered, particularly with respect to causal associations between variables. The evidence reviewed indicates that depression, anxiety, low quality of life, and poor sleep are associated with pain in painful diabetic neuropathy. The disproportionate lack of research into psychological treatments for painful diabetic neuropathy represents a significant opportunity for future research.

Funder

National Institute for Health Research

Biomedical Research Centre at South London

Maudsley National Health Service

Foundation Trust and King’s College London

Publisher

Oxford University Press (OUP)

Subject

Anesthesiology and Pain Medicine,Neurology (clinical),General Medicine

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