{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T18:37:46Z","timestamp":1793731066866,"version":"4.6.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n \n Diabetic foot ulcer (DFU) is a significant global health concern due to its substantial burden on individuals and healthcare systems. In addition to its physical impact, DFU has emotional effects on patients. This study analyzed the effects of inhaling clary sage (CS;\n Salvia sclarea<\/jats:italic>\n L.) or linalyl acetate (LA) on depression and psychological factors in patients with DFU.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This study, performed at the Diabetic Wound Center, enrolled DFU patients, categorized as having mild or moderate to severe depression based on visual analog scale (VAS) for depression scores. Patients were randomized to inhalation of 5% CS oil, 5% LA or almond oil (control) by natural breathing. Blood pressure, heart rate, Depression-VAS, Anxiety-VAS, and Stress-VAS were measured before and after inhalation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n This study enrolled 72 patients with DFU, including 43 with mild and 29 with moderate to severe depression. Of the 43 patients with mild depression, 14, 14, and 15 were randomized to inhalation of CS, LA, and almond oil, respectively. Of the 29 patients with moderate to severe depression, 9, 11, and 9 were randomized to inhalation of CS, LA, and almond oil, respectively. Compared with inhalation of almond oil, inhalation of CS oil significantly reduced stress (\n p<\/jats:italic>\n &lt;\u202f0.05) and (\n p<\/jats:italic>\n &lt;\u202f0.01) in patients with mild depression, whereas inhalation of LA significantly reduced anxiety-VAS (\n p<\/jats:italic>\n &lt;\u202f0.05) and depression-VAS (\n p<\/jats:italic>\n &lt;\u202f0.05) in patients with moderate to severe depression.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Inhalation of CS oil may have the potential to alleviate stress and anxiety in DFU patients with mild depression, whereas inhalation of LA may have the potential to alleviate anxiety and depression in DFU patients with moderate to severe depression. These findings suggest that adjunct therapy in DFU patients should be individualized according to the degree of depression.<\/jats:p>\n <\/jats:sec>\n \n Clinical trial registration<\/jats:title>\n \n http:\/\/cris.nih.go.kr\/<\/jats:uri>\n , identifier KCT0009722.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2025.1523441","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:19:26Z","timestamp":1737505166000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Differential effects of clary sage (Salvia sclarea L.) oil and linalyl acetate on depression levels in diabetic foot ulcer patients with T2DM: a randomized blinded controlled trial"],"prefix":"10.3389","volume":"12","author":[{"given":"Ji Won","family":"Son","sequence":"first","affiliation":[{"name":"Department of Basic Nursing Science, College of Nursing, Korea University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Purum","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Nursing, College of Nursing, Woosuk University","place":["Jeonju, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun Seek","family":"Min","sequence":"additional","affiliation":[{"name":"Department of Physiology and Biophysics, Eulji University School of Medicine","place":["Daejeon, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geun Hee","family":"Seol","sequence":"additional","affiliation":[{"name":"Department of Basic Nursing Science, College of Nursing, Korea University","place":["Seoul, Republic of Korea"]},{"name":"BK21 FOUR Program of Transdisciplinary Major in Learning Health Systems, Graduate School, Korea University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1001\/jama.2023.10578","article-title":"Diabetic foot ulcers: a review","volume":"330","author":"Armstrong","year":"2023","journal-title":"JAMA"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"209","DOI":"10.2337\/dci22-0043","article-title":"Etiology, epidemiology, and disparities in the burden of diabetic foot ulcers","volume":"46","author":"McDermott","year":"2023","journal-title":"Diabetes Care"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2019\/4706720","article-title":"Factors associated with health-related quality of life among Jordanian patients with diabetic foot ulcer","volume":"2019","author":"Alrub","year":"2019","journal-title":"J Diabetes 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Oil and its active constituent Linalyl acetate alleviate pain and urinary residual sense after colorectal Cancer surgery: a randomised controlled trial","volume":"2017","author":"Yu","year":"2017","journal-title":"Evid Based Complement Alternat Med"},{"key":"ref18","volume-title":"Aromatherapies and stress: an examination of saliva Sclarea in acute stress","author":"Van Gundy","year":"2024"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"267","DOI":"10.7586\/jkbns.2021.23.4.267","article-title":"Inhalation of clary sage oil before chemotherapy alleviates anxiety and stress without changing blood pressure: a randomized controlled trial","volume":"23","author":"Kim","year":"2021","journal-title":"J Korean Biol Nurs Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1007\/s13596-019-00420-x","article-title":"Clary sage essential oil and its biological activities","volume":"20","author":"Mahboubi","year":"2020","journal-title":"Adv Tradit Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"100193","DOI":"10.1016\/j.obmed.2020.100193","article-title":"Effect of clary sage oil as an aromatherapy on cardiac autonomic function among patients with premenstrual syndrome\u2013a randomized controlled study","volume":"18","author":"Geethanjali","year":"2020","journal-title":"Obes Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1016\/j.neuroscience.2005.06.090","article-title":"Catecholamines mediate stress-induced increases in peripheral and central inflammatory cytokines","volume":"135","author":"Johnson","year":"2005","journal-title":"Neuroscience"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1097\/01.fjc.0000238589.00365.42","article-title":"Linalyl acetate as a major ingredient of lavender essential oil relaxes the rabbit vascular smooth muscle through dephosphorylation of myosin light chain","volume":"48","author":"Koto","year":"2006","journal-title":"J Cardiovasc Pharmacol"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1055\/a-1211-6325","article-title":"Clary sage essential oil and its effect on human mood and pulse rate: an in vivo pilot study","volume":"86","author":"Mitic","year":"2020","journal-title":"Planta Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"280","DOI":"10.5812\/numonthly.60280","article-title":"Effects of aromatherapy using the damask rose essential oil on depression, anxiety, and stress in hemodialysis patients: a clinical trial","volume":"9","author":"Dehkordi","year":"2017","journal-title":"Nephrourol Mon"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1016\/j.explore.2020.12.012","article-title":"The effects of lavender and chamomile essential oil inhalation aromatherapy on depression, anxiety and stress in older community-dwelling people: a randomized controlled trial","volume":"18","author":"Ebrahimi","year":"2022","journal-title":"Explore"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1053\/j.jfas.2024.07.005","article-title":"Depression as a prognostic factor in lower extremity amputation for diabetic foot: insights from a prospective study on wound healing, infections, and early mortality","volume":"63","author":"Korkmaz","year":"2024","journal-title":"J Foot Ankle Surg"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1523441\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T14:30:10Z","timestamp":1791556210000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1523441\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,22]]},"references-count":27,"alternative-id":["10.3389\/fmed.2025.1523441"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1523441","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,22]]},"article-number":"1523441"}}