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01-12-2014 | Research | Uitgave 1/2014 Open Access

Journal of Foot and Ankle Research 1/2014

High levels of anxiety and depression in diabetic patients with Charcot foot

Journal of Foot and Ankle Research > Uitgave 1/2014
Zahra Chapman, Charles Matthew James Shuttleworth, Jörg Wolfgang Huber
Belangrijke opmerkingen

Electronic supplementary material

The online version of this article (doi:10.​1186/​1757-1146-7-22) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contribution

ZC developed the idea for the study, collected all the data and road an initial report as part of her MSc dissertation which was supervised by JH. CH and ZC jointly produced the initial manuscript. CH updated literature searches as part of producing the manuscript. JH produced the figures, carried out comparison analysis with other HADS data and revised the manuscript. All authors read and approved the final manuscript.



Charcot foot is a rare but devastating complication of diabetes. Little research is available on the mental health impact of Charcot foot. Aim of the study is to assess mental health in diabetes patients with Charcot foot and to investigate the moderating effects of socio-demographic factors. The severity of the problem will be statistically evaluated with the help of a reference data set.


Cross-sectional questionnaire data using the Hospital Anxiety and Depression Scale (HADS) and demographic background were collected from 50 patients with diabetes and Charcot complications (males 62%; mean age 62.2 ± 8.5 years). Statistical comparisons with a large data set of general diabetes patients acting as a point of reference were carried out.


Anxiety and depression levels were high, (anxiety and depression scores 6.4 ± 4 and 6.3 ± 3.6 respectively). Females reported more severe anxiety and depression. Ethnic minorities and patients out of work reported more severe anxiety. Comparisons with published HADS data indicate that diabetes patients with Charcot foot experience more serious levels of anxiety and depression.


The high levels of mental health problems which were found in this study in diabetes patients with Charcot foot require recognition by researchers and clinicians. The findings imply the need to screen for mental health problems in diabetes patients with Charcot foot.

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Extra materiaal
Authors’ original file for figure 1
Authors’ original file for figure 2
Authors’ original file for figure 3
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Reviewer acknowledgement

Reviewer acknowledgement 2013