{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T05:56:43Z","timestamp":1791266203205,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Foot and Ankle Research"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>There is close association between experience of diabetes\u2010tissue complications and depression\/psychological distress. Our aim was to describe the results of prospective screening for anxiety\/depression in a high\u2010risk multidisciplinary foot hospital clinic where people present with diabetes foot ulceration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty patients attending our podiatry clinic participated in this study. All had active foot ulceration. The scales completed were GAD\u20107 for anxiety\/PHQ\u20109 for depression plus 2\u2010specific diabetes distress scale items (16\u00a0+\u00a02 questions). Spearman's rho(\u03c1) was utilised for correlational analysis due to the skewed distributions of variables. Medical history was obtained from primary and secondary care electronic health records. Inclusion criteria were type 1 or 2 diabetes and active foot ulceration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eight patients were diagnosed with type 1 diabetes and 42 with type 2 diabetes. Mean (standard deviation) (sd) age of the study population was 65.4 (12.9) years (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a050) of which 86.7% were men. Median time since diagnosis was 14.5 (3.1) years. 42% of the patients had CKD (estimated GFR\u00a0&lt;\u00a060\u00a0mL\/min\/1.73\u00a0m\n                      <jats:sup>2<\/jats:sup>\n                      ). Median (IQR) for PHQ\u20109 was 9 (3\u201316) and GAD\u20107 was 4 (0.5\u20139.0) (mild\u2010moderate median scores for both). The median (IQR) of number of comorbidities was 8.3 (3.9); number of separate drugs was 10.5 (4.1). Depression\/anxiety scores correlated highly positively with each other (Spearman's rho 0.791,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001) and with the diabetes distress score. Age was significantly and inversely correlated with anxiety (rho \u22120.472,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.017) and depression (rho \u22120.250,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.040). The PHQ\u20109 questionnaire score for depression was higher in people taking more individual pharmacological agents (0.490,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001) and in people with a higher HbA1c (rho 0.421,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.007) and correlated with the total of the 2 diabetes distress score items (rho 0.456,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.006). Ulcer healed status at 12\u00a0weeks was not associated with any questionnaire score. Insulin treatment was associated with higher PHQ\u20109 score.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this prospective study, we found a high correlation between depression\/anxiety symptoms and diabetes foot ulceration, both recognised and unrecognised (until assessment). Both depression and anxiety symptoms declined with age. Higher depression scores associated with a higher current HbA1c and with greater number of prescribed medications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jfa2.70208","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T04:36:51Z","timestamp":1789706211000},"source":"Crossref","is-referenced-by-count":0,"title":["Screening for Depression and Anxiety in People With Diabetes and a Foot Ulcer in the Podiatry Clinic"],"prefix":"10.1002","volume":"19","author":[{"given":"Emma","family":"Fletcher","sequence":"first","affiliation":[{"name":"Diabetes and Endocrinology Salford Royal Hospital  Salford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5492-8616","authenticated-orcid":false,"given":"Matthew","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Podiatry Salford Royal Hospital  Salford 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