Huzursuz Bacak Sendromu Tanılı Hastalarda Anksiyete, Depresyon Ve Yeme Bozukluklarının İncelenmesi

Abstract

AMAÇ: Huzursuz bacak sendromu (HBS), depresyon, anksiyete ve yeme bozukluğu gibi psikiyatrik belirtilerle sıklıkla ilişkilendirilmektedir. Bu çalışmada HBS şiddeti ile depresyon, anksiyete ve yeme bozukluğu riski arasındaki ilişkinin değerlendirilmesi amaçlanmıştır.

GEREÇ ve YÖNTEM: Retrospektif olarak planlanan çalışmaya HBS tanısı alan 72 hasta ve yaş-cinsiyet açısından eşleştirilmiş 44 sağlıklı kontrol dahil edildi. Depresyon, anksiyete ve yeme davranışları sırasıyla Beck Depresyon Envanteri (BDE), Beck Anksiyete Envanteri (BAE) ve Yeme Tutum Testi (YTT-40) ile değerlendirildi. Gruplar arasında demografik veriler ve ölçek puanları karşılaştırıldı. Depresyon ve anksiyete şiddeti kategorileri ayrıca analiz edildi.

BULGULAR: HBS grubunda BDE ve BAE puanları kontrol grubuna göre anlamlı olarak daha yüksekti (sırasıyla p=0,008 ve p=0,001). Hafif, orta ve ağır depresyon belirtileri HBS hastalarında daha sık görüldü. Anksiyete şiddeti de hastalarda belirgin şekilde yüksekti; ağır anksiyete HBS grubunda %37,5 iken, kontrolde %9,1 oranında izlendi. YTT-40 puanları ve yeme bozukluğu riski HBS grubunda daha yüksek olmakla birlikte istatistiksel olarak anlamlı değildi (p=0,267). VKİ hasta grubunda daha yüksek olsa da anlamlı farklılık göstermedi.

SONUÇ: HBS hastalarında depresyon ve anksiyete düzeyleri belirgin derecede yüksektir ve bu durum hastalığın önemli bir nöropsikiyatrik bileşen taşıdığını göstermektedir. Yeme bozukluğu eğilimleri HBS hastalarında daha sık gözlense de bu ilişkinin netleşmesi için daha geniş örneklemli çalışmalara ihtiyaç vardır. HBS’nin klinik yönetiminde psikiyatrik değerlendirmenin entegrasyonu, yaşam kalitesinin artırılmasına katkı sağlayabilir.

Keywords

• Huzursuz bacak sendromu
• depresyon
• anksiyete
• yeme bozukluğu riski

Assessment of Anxiety, Depression, and Eating Disorder Symptoms Among Patients with Restless Legs Syndrome

Abstract

OBJECTIVE: Restless legs syndrome (RLS) is frequently accompanied by psychiatric symptoms such as depression, anxiety, and disordered eating behaviors. This study aimed to investigate the association between RLS severity, depression, anxiety, and the risk of eating disorders. MATERIALS and METHODS: This retrospective study included 72 patients diagnosed with RLS and 44 age- and sex-matched healthy controls. Depression, anxiety, and eating behaviors were assessed using the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Eating Attitudes Test (EAT-40), respectively. Demographic data and scale scores were compared between groups. Depression and anxiety severity categories were also analyzed.

RESULTS: BDI and BAI scores were significantly higher in the RLS group compared with the control group (p=0.008 and p=0.001, respectively). Mild, moderate, and severe depressive symptoms were more common among RLS patients. Anxiety severity was also markedly higher in the patient group, with severe anxiety observed in 37.5% of patients compared with 9.1% of controls. Although EAT-40 scores and the frequency of eating disorder risk were higher in the RLS group, the differences were not statistically significant (p=0.267). BMI was slightly higher in the patient group but did not reach statistical significance.

CONCLUSION: RLS is associated with significantly increased levels of depression and anxiety, highlighting a substantial neuropsychiatric burden in affected individuals. Although disordered eating tendencies appeared more common in RLS patients, further studies with larger samples are needed to clarify this relationship. Integrating psychiatric evaluation into the routine management of RLS may improve clinical outcomes and overall quality of life.

Keywords

• Restless legs syndrome
• depression
• anxiety
• eating disorder risk

References

1. 1. Trotti LM. Restless legs syndrome and sleep-related movement disorders. Continuum (Minneap Minn). 2017; 23: 1005-1016. doi: 10.1212/CON.0000000000000488
2. 2. Merlino G, Valente M, Serafini A, Gigli GL. Restless legs syndrome: diagnosis, epidemiology, classification and consequences. Neurol Sci. 2007; 28(Suppl 1): S37-S46. doi: 10.1007/s10072-007-0736-x
3. 3. Wijemanne S, Ondo W. Restless legs syndrome: clinical features, diagnosis and a practical approach to management. Pract Neurol. 2017; 17: 444-452. doi: 10.1136/practneurol-2017-001762
4. 4. Rinaldi F, Galbiati A, Marelli S, Cusmai M, Gasperi A, Oldani A, et al. Defining the phenotype of restless legs syndrome/Willis-Ekbom disease (RLS/WED): a clinical and polysomnographic study. J Neurol. 2016; 263: 396-402. doi: 10.1007/s00415-015-7994-y
5. 5. Patrick LR. Restless legs syndrome: pathophysiology and the role of iron and folate. Altern Med Rev. 2007; 12: 101-112.
6. 6. Paulus W, Dowling P, Rijsman R, Stiasny-Kolster K, Trenkwalder C, de Weerd A. Pathophysiological concepts of restless legs syndrome. Mov Disord. 2007; 22: 1451-1456. doi: 10.1002/mds.21533
7. 7. Kim TJ, Yoon JE, Park JA, Lee SK, Chu MK, Yang KI, et al. Prevalence and characteristics of restless legs syndrome in Korean adults: a study in two independent samples of the general population. Neuroepidemiology. 2019; 52: 193- 204. doi: 10.1159/000496839
8. 8. Allen RP. Controversies and challenges in defining the etiology and pathophysiology of restless legs syndrome. Am J Med. 2007; 120(1 Suppl 1): S13-S21. doi: 10.1016/j. amjmed.2006.11.003

9. 9. Huo N, Smith CY, Rocca LG, Rocca WA, Mielke MM. Association of premenopausal bilateral oophorectomy with restless legs syndrome. JAMA Netw Open. 2021; 4: e2036058. doi: 10.1001/jamanetworkopen.2020.36058
10. 10. Antelmi E, Rocchi L, Latorre A, Belvisi D, Magrinelli F, Bhatia KP, et al. Restless legs syndrome: known knowns and known unknowns. Brain Sci. 2022; 12: 118. doi: 10.3390/brainsci12010118
11. 11. Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, et al. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med. 2003; 4: 121-132. doi: 10.1016/s1389-9457(02)00258-7
12. 12. Jackson-Koku G. Beck Depression Inventory. Occup Med (Lond). 2016; 66: 174-175. doi: 10.1093/occmed/kqv087
13. 13. Wilson KA, Chambless DL, de Beurs E. Beck Anxiety Inventory. In: Antony MM, Barlow DH, editors. Handbook of Assessment and Treatment Planning for Psychological Disorders. 3rd ed. New York: Guilford Press; 2004: 399-421.
14. 14. Garfinkel PE, Newman A. The eating attitudes test: twenty-five years later. Eat Weight Disord. 2001; 6: 1-24. doi: 10.1007/BF03339747
15. 15. Trenkwalder C, Allen R, Högl B, Paulus W, Winkelmann J. Restless legs syndrome associated with major diseases: a systematic review and new concept. Neurology. 2016; 86: 1336-1343. doi: 10.1212/WNL.0000000000002542
16. 16. Sevim S, Dogu O, Kaleagasi H, Aral M, Metin O, Camdeviren H. Correlation of anxiety and depression symptoms in patients with restless legs syndrome: a population-based survey. J Neurol Neurosurg Psychiatry. 2004; 75: 226-230. doi: 10.1136/jnnp.2003.017467
17. 17. Koo BB, Blackwell T, Lee HB, Stone KL, Louis ED, Redline S, et al. Restless legs syndrome and depression: effect mediation by disturbed sleep and periodic limb movements. Am J Geriatr Psychiatry. 2016; 24: 1105-1116. doi: 10.1016/j.jagp.2016.04.003
18. 18. Cho CH, Kim L, Lee HJ. Individuals with restless legs syndrome tend to have severe depressive symptoms: findings from a community-based cohort study. Psychiatry Investig. 2017; 14: 887-893. doi: 10.4306/pi.2017.14.6.887
19. 19. Mackie S, Winkelman JW. Restless legs syndrome and psychiatric disorders. Sleep Med Clin. 2015; 10: 351-357. doi: 10.1016/j.jsmc.2015.05.009
20. 20. Provini F, Antelmi E, Vignatelli L, Zaniboni A, Naldi G, Calandra-Buonaura G, et al. Association of restless legs syndrome with nocturnal eating: a case-control study. Mov Disord. 2009; 24: 871-877. doi: 10.1002/mds.22460
21. 21. Howell MJ, Schenck CH. Restless nocturnal eating: a common feature of Willis-Ekbom syndrome (RLS). J Clin Sleep Med. 2012; 8: 413-419. doi: 10.5664/jcsm.2036
22. 22. Marconi S, Scarlatti F, Rizzo G, Antelmi E, Innamorati M, Pompili M, et al. Is nocturnal eating in restless legs syndrome linked to a specific psychopathological profile?A pilot study. J Neural Transm (Vienna). 2015; 122: 1563-1571. doi: 10.1007/s00702-015-1435-z
23. 23. Antelmi E, Vinai P, Pizza F, Marcatelli M, Speciale M, Provini F. Nocturnal eating is part of the clinical spectrum of restless legs syndrome and an underestimated risk factor for increased body mass index. Sleep Med. 2014; 15: 168-172. doi: 10.1016/j.sleep.2013.08.796