الفهرس 
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Abstract
Painful Diabetic Peripheral Neuropathy is one of the most common diseases of peripheral nervous system in adults . The present study is performed on 100 patients who were were fulfilling inclusion criteria and diagnosed as distal symmetrical sensorimotor polyneuropathy without any other systemic diabetic complication based on clinical,investigatory tools and nerve conduction study findings In Assiut University Hospital at Neuropsychiatric Department within six months from September 1st 2019 to February 29th 2020 to determine psychiatric comorbidities in patients with painful DM peripheral neuropathy.To estimate the psychiatric comorbidities in patients with painful DM peripheral neuropathy clinical rating scales were done . All patients were subjected to the following;Visual Analogue Scale VAS for pain assessment , Brief Pain Inventory BPI for pain and quality of life assessment , Hamilton depression and anxiety rating scales HAM-D & HAM-A for estimation of depression and anxiety , Pittsburgh sleep quality index PSQI for sleep pattern , The MOS 36-Item Short-Form Health Survey (SF-36) for assessment of quality of life , Montreal cognitive assessment MOCA& Mini-Mental state examination MMSE for cognitive function assessment . The results of the present study were revealing that; mean age of studied PDPN patients was 51±12.8 years with mean duration of DM 10.2±7.4years, while mean HbA1C% of them was 7.3±0.9. 55% of PDPN cases were males , 59% were rural , 61% were not working(indicate low socioeconomic state) ,53% were on oral hypoglycemic drugs and 62% were not educated . According to VAS scale (327) , patients with PDPN are divided into 3 groups:mild 29 patients (29%) , moderate 39 patients (39%) , severe 32 patients (32%) . On assessment of pain and quality of life using BPI (328) , PDPN patients had significant impairment of quality of life in all functioning domains of BPI scale among different severity pain groups in PDPN measured by VAS (p=0.000). Based on HAM-D (329) , 65.6% of severe PDPN suffered from moderate and severe depression symptoms compared to other severity pain groups , also mean HAM-D Scale scores are significantly high among severe pain PDPN group symptoms compared to other severity pain groups (p=0.000). Based on HAM-A (330) , 65.6% of severe PDPN suffered from significant high moderate and severe anxiety symptoms compared to other severity pain groups , also mean HAM-A Scale scores are significantly high among severe pain PDPN group symptoms compared to other severity pain groups (p=0.000). On assessment of sleep using PSQI scale (331) , PDPN patients had significant impairment of quality of sleep among different pain severity groups in PDPN patients and highest score among group had severe pain (p=0.000). On assessment of quality of life using SF-36 (332) , we found deterioration in all domains of SF36 among PDPN patients with increasing severity of pain in PDPN measured by VAS (p=0.000). Also we assess cognitive function using MMSE scale (321) , 87.5% of severe PDPN suffered from mild cognitive dysfunction measured by MMSE. Near half of total PDPN patients had mild significant impairment in cognitive functions based on MoCA (322) and worst score was among severe pain group compared to other pain groups (p=0.0001) . To estimate the relationship between VAS score and demographics , clinical data and clinical rating scales. It was found the following; There is positive correlation between VAS pain score with age and HbA1C% among PDPN patients ( p=0.004 , r=0.283 ,p=0.000 , r=0.135 respectively), No significant correlation between VAS pain severity and smoking habit in patients with PDPN (p=0.385 ) . There is positive correlation between VAS pain score and BPI regarding all items among PDPN patients (p=0.000 , r=0.988 , r=0.952 , 0.903 , 0.892 , 0.912 , 0.884 , 0.797 , 0.883 and 0.864 respectively). There is positive correlation between VAS pain severity and HAM-D & HAM-A among PDPN patients (p=0.000 , r=0.711 , 0.711 respectively). There is positive correlation between VAS pain severity and PSQI regarding all items of sleep quality among PDPN patients (p=0.000 , r=0.771). There is negative correlation between VAS pain severity and SF-36 in all domains among PDPN patients (p=0.000 , r= -0.896 , -0.777 , -0.811 , - 0.808 ,-0.803 , -0.717 , -0.841 and -0.852 respectively). There is negative correlation between VAS pain severity and MOCA&MMSE among PDPN patients (p=0.000 , r=-0.624 ,r=-0.708 respectively).