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Restless legs syndrome and depression-anxiety disorder association in iron deficiency anemia patients

Year 2014, Volume: 31 Issue: 4, 0 - , 30.01.2015

Abstract

Restless Legs Syndrome (RLS) is a disorder in which the person experiences a strong urge to move their legs or other extremities during rest. This urge to move is associated with tingling, pulling or other unpleasant and uncomfortable feelings; it usually slowl increases in the affected limb and often affects sleep. The incidence in general population is 5-15%. Although the pathophysiology is not fully understood, it was thought to result from the iron and dopamine metabolism irregularities and also has a genetic component. There are publications that show the frequency of disease in patients with iron deficiency or renal failure reaches up to 80%. In this study, we investigated the incidence of restless leg syndrome in anemic patients without any other organic disease or drug use, which can cause restless legs syndrome. We also tried to find out if there is a relation between restless legs syndrome, ferritin levels, anxiety and depression. Our retrospective, cross sectional study was made in The Ministry of Health and family medicine, neurology and psychiatry outpatient clinics of Ordu University Education and Research Hospital. 47 patients who were admitted to above mentioned clinics whose ferritin levels were under 50 ng/ml without any other disease and were not on medication (including those indicated for iron deficiency anemia) was included in to the study. All patients were given the Beck depression inventory and Beck anxiety inventory. The patients were questioned in terms of the basic diagnostic criteria established by International Restless Legs Syndrome Study Group. Definitive diagnosis could be established by the patients that meet the four criterias for the diagnosis. International Restless Legs Scale applied to patients diagnosed with RLS. Of 47 patients, 39 were female and 8 were male. 28 (%59.6) of the patients met the criteria of RLS. 28 patients with a diagnosis of RLS; 4 of them mild, 11 of them moderate, 8 of them severe and 5 of them experienced very severe symptoms of RLS. The relationship between the RLS and ferritin levels were checked and there was no statistically significant difference between them. A significant difference was not found in Beck depression scores between patients with and without RLS, but when the groups were compared in terms of Beck anxiety score, there were a significant difference. There was no significant relationship between RLS severity and Beck depression or Beck anxiety scores. RLS can be seen in %5-15 of general population and it is much more likely to emerge in the presence of an organic problem such as iron deficiency anemia. The diagnosis of the disorder is set clinically and RLS had a different significance because it may cause sleep disturbances and psychiatric disorders. If not questioned, this problem, which is not easily noticeable, can lead to misdiagnosis and misinterpreted as an anxiety disorder or a primary sleep disorder. Therefore the symptoms that could be corrected only by iron deficiency treatment, could be inşamed further by giving antidepressants and hypnotics.

References

  • Abetz, L., Allen, R., Follet, A., Washburn, T., Earley, C., Kirsch, J, Knight, H., 2004. Evaluating the quality of life of patients with restless legs syndrome. Clin. Ther. 26, 925-935. doi:10.1016/S0149-2918(04)90136-1.
  • Allen, R.P., Earley, C.J., 2001. Restless legs syndrome: A review of clinical and pathophysiologic features. J. Clin. Neurophysiol. 18, 128-147. http://dx.doi.org/10.1097/00004691-200103000-00004.
  • Allen, R.P., Walters, A.S., Montplaisir, J., Hening, W., Myers, A., Bell, T.J., Ferini-Strambi, L., 2005. Restless legs syndrome prevalence and impact. REST general population study. Arch. Intern. Med. 165, 1286-1292. doi:10.1001/archinte.165.11.1286.
  • Barriere, G., Cazalets, J.R., Bioulac, B., Tison, F., Ghorayeb, I., 2005. The restless legs syndrome. Prog. Neurobiol. 77, 139-165. doi:10.1016/j. pneurobio.2005.10.007.
  • Beutler, E., Lichman, M.A., Coller, B.S.,1995. Iron deficiency, Ed. Williams, E., Hematology fifth edition. Philadelphia. pp: 490-511.
  • Chokroverty, S., 2009. Restless Legs syndrome. Sleep Disorders. Third Edition. Chapter 72, 1799-1801.
  • Earley, CJ., Connor, JR., Beard, JL,, Malecki, EA., Epstein, DK., Allen, RP., 2000. Abnormalities in CSF concentration of ferritin and transferin in restless legs syndrome. Neurology. 54, 1698-1700. doi: 10.1212/WNL.54.8.1698.
  • Garcia-Borreguero, D., Egatz, R., Winkelmann, J., Berger, K., 2006. Epidemiology of restless legs syndrome: The current status. Sleep Medicine Reviews.10, 153-167. doi:10.1016/j.smrv.2006.01.001.
  • Hening, W.A., Walters, A.S., LeBroca, C., Hirsch, L., Dhar, A., IRLSSG Mot., 2001. The International RLS study group rating scale: A reliable and valid instrument for assessing severity of the restless legs syndrome. Neurology. 56, 4.
  • Hening, W., Walters, A.S., Allen, R.P., Montplaisir, J., Myers, A., Ferini-Strambi, L., 2004. Impact, diagnosis and treatment of restess legs syndrome in a primary care population: The REST primary care study. Sleep Medicine. 5, 237-246. doi:10.1016/j.sleep.2004.03.006.
  • Holley, J.L., Nespor, S., Rault, R., 1992. A comparison of reported sleep disorders in patients on chronic hemodialysis and continuous peritoneal dialysis. Am. J. Kidney Dis. 19, 156-161. doi:10.1016/S0272-6386(12)70125-7.
  • Kaynak, K.D., 2007. İnsomni yakınması ardında yatan uyku bozuklukları; huzursuz bacak sendromu ve uykuda periyodik hareket bozukluğu. Nöropsikiyatri Arşivi. 44, 95-100.
  • Mizuno, S., Mihara, T., Miyaoka, T., Inagaki, T., Horiguchi, J., 2005. CSF iron, ferritin and transferin levels in restless legs syndrome. J. Sleep Res.14, 43-47. doi: 10.1111/j.1365-2869.2004.00403.x.
  • Mosko, S., Zetin, M., Glen, S., Ganber, D., DeAntonio, M., Sassin, J., Mc Anich, J., Warren, S., 1989. Self-reported depressive symptomatology, mood rating and treatment outcome in sleep disorder patients. J. Clin. Psychol. 4, 51-60. doi.org/10.1002/1097-4679(198901)45:1.
  • Ondo, W. Jankovic, J., 1996. Restless legs syndrome: Clinico etiologic correlates. Neurology. 47, 1435-1441. doi:10.1212/wnl.47.6.1435.
  • Özcan, T.A., Meral, H., Özcan, H., 2013. Ordu üniversitesi öğrencileri arasında huzursuz bacak sendromu sıklığı, özellikleri ve farkındalığı. Nöropsikiyatri Arşivi. 50, 175-179. doi: 10.4274/npa.y6550.
  • Picchietti, D., Winkelman, J.W., 2005. Restless legs syndrome, periodic limb movements in sleep and depression. Sleep. 28, 891-898. doi:10.1016/j.sleep.2005.12.009.
  • Coşar, S., S.N., Yoldaş, A., Öztop, P., Yemişci, O.Ü., Ayaş, Ş., 2012. Osteoartriti olan yaşlılarda huzursuz bacak sendromu. Türk Geriatri Dergisi. 15, 30-33.
  • Sevim, S., Doğu, O., Kaleagasi, H., Aral, M., Metin, O., Çamdeviren H., 2004. Correlation of anxiety and depression symptoms in patients with restless legs syndrome: A population based survey. J. Neurol. Neurosurg. Psychiatry. 75, 226-230.
  • Stiasny, K., Wetter, T.C., Trenkwalder, C., Oertel, W.H., 2000. Restless legs syndrome and its treatment by dopamine agonists. Parkinsonism Relat. Disord. 7, 21-25. doi.org/10.1016/S1353-8020(00)00041-9.
  • Trenkwalder, C., Paulus, W., Walters, AS., 2005. The restless legs syndrome. Lancet Neurol. 4, 465-475. doi:10.1016/S1474-4422(05)70139-3.
  • Tuncel, D., Orhan, F.Ö., Karaaslan, M.F., 2009. The levels of depression and somatization in restless legs syndrome. Klinik Psikofarmakoloji Bülteni. 19, 143-147.
  • Walters, A.S., 1995. Toward a better definition of the restless legs syndrome. The international restless legs syndrome study Group. Mov. Disord. 10, 634-642.
Year 2014, Volume: 31 Issue: 4, 0 - , 30.01.2015

Abstract

References

  • Abetz, L., Allen, R., Follet, A., Washburn, T., Earley, C., Kirsch, J, Knight, H., 2004. Evaluating the quality of life of patients with restless legs syndrome. Clin. Ther. 26, 925-935. doi:10.1016/S0149-2918(04)90136-1.
  • Allen, R.P., Earley, C.J., 2001. Restless legs syndrome: A review of clinical and pathophysiologic features. J. Clin. Neurophysiol. 18, 128-147. http://dx.doi.org/10.1097/00004691-200103000-00004.
  • Allen, R.P., Walters, A.S., Montplaisir, J., Hening, W., Myers, A., Bell, T.J., Ferini-Strambi, L., 2005. Restless legs syndrome prevalence and impact. REST general population study. Arch. Intern. Med. 165, 1286-1292. doi:10.1001/archinte.165.11.1286.
  • Barriere, G., Cazalets, J.R., Bioulac, B., Tison, F., Ghorayeb, I., 2005. The restless legs syndrome. Prog. Neurobiol. 77, 139-165. doi:10.1016/j. pneurobio.2005.10.007.
  • Beutler, E., Lichman, M.A., Coller, B.S.,1995. Iron deficiency, Ed. Williams, E., Hematology fifth edition. Philadelphia. pp: 490-511.
  • Chokroverty, S., 2009. Restless Legs syndrome. Sleep Disorders. Third Edition. Chapter 72, 1799-1801.
  • Earley, CJ., Connor, JR., Beard, JL,, Malecki, EA., Epstein, DK., Allen, RP., 2000. Abnormalities in CSF concentration of ferritin and transferin in restless legs syndrome. Neurology. 54, 1698-1700. doi: 10.1212/WNL.54.8.1698.
  • Garcia-Borreguero, D., Egatz, R., Winkelmann, J., Berger, K., 2006. Epidemiology of restless legs syndrome: The current status. Sleep Medicine Reviews.10, 153-167. doi:10.1016/j.smrv.2006.01.001.
  • Hening, W.A., Walters, A.S., LeBroca, C., Hirsch, L., Dhar, A., IRLSSG Mot., 2001. The International RLS study group rating scale: A reliable and valid instrument for assessing severity of the restless legs syndrome. Neurology. 56, 4.
  • Hening, W., Walters, A.S., Allen, R.P., Montplaisir, J., Myers, A., Ferini-Strambi, L., 2004. Impact, diagnosis and treatment of restess legs syndrome in a primary care population: The REST primary care study. Sleep Medicine. 5, 237-246. doi:10.1016/j.sleep.2004.03.006.
  • Holley, J.L., Nespor, S., Rault, R., 1992. A comparison of reported sleep disorders in patients on chronic hemodialysis and continuous peritoneal dialysis. Am. J. Kidney Dis. 19, 156-161. doi:10.1016/S0272-6386(12)70125-7.
  • Kaynak, K.D., 2007. İnsomni yakınması ardında yatan uyku bozuklukları; huzursuz bacak sendromu ve uykuda periyodik hareket bozukluğu. Nöropsikiyatri Arşivi. 44, 95-100.
  • Mizuno, S., Mihara, T., Miyaoka, T., Inagaki, T., Horiguchi, J., 2005. CSF iron, ferritin and transferin levels in restless legs syndrome. J. Sleep Res.14, 43-47. doi: 10.1111/j.1365-2869.2004.00403.x.
  • Mosko, S., Zetin, M., Glen, S., Ganber, D., DeAntonio, M., Sassin, J., Mc Anich, J., Warren, S., 1989. Self-reported depressive symptomatology, mood rating and treatment outcome in sleep disorder patients. J. Clin. Psychol. 4, 51-60. doi.org/10.1002/1097-4679(198901)45:1.
  • Ondo, W. Jankovic, J., 1996. Restless legs syndrome: Clinico etiologic correlates. Neurology. 47, 1435-1441. doi:10.1212/wnl.47.6.1435.
  • Özcan, T.A., Meral, H., Özcan, H., 2013. Ordu üniversitesi öğrencileri arasında huzursuz bacak sendromu sıklığı, özellikleri ve farkındalığı. Nöropsikiyatri Arşivi. 50, 175-179. doi: 10.4274/npa.y6550.
  • Picchietti, D., Winkelman, J.W., 2005. Restless legs syndrome, periodic limb movements in sleep and depression. Sleep. 28, 891-898. doi:10.1016/j.sleep.2005.12.009.
  • Coşar, S., S.N., Yoldaş, A., Öztop, P., Yemişci, O.Ü., Ayaş, Ş., 2012. Osteoartriti olan yaşlılarda huzursuz bacak sendromu. Türk Geriatri Dergisi. 15, 30-33.
  • Sevim, S., Doğu, O., Kaleagasi, H., Aral, M., Metin, O., Çamdeviren H., 2004. Correlation of anxiety and depression symptoms in patients with restless legs syndrome: A population based survey. J. Neurol. Neurosurg. Psychiatry. 75, 226-230.
  • Stiasny, K., Wetter, T.C., Trenkwalder, C., Oertel, W.H., 2000. Restless legs syndrome and its treatment by dopamine agonists. Parkinsonism Relat. Disord. 7, 21-25. doi.org/10.1016/S1353-8020(00)00041-9.
  • Trenkwalder, C., Paulus, W., Walters, AS., 2005. The restless legs syndrome. Lancet Neurol. 4, 465-475. doi:10.1016/S1474-4422(05)70139-3.
  • Tuncel, D., Orhan, F.Ö., Karaaslan, M.F., 2009. The levels of depression and somatization in restless legs syndrome. Klinik Psikofarmakoloji Bülteni. 19, 143-147.
  • Walters, A.S., 1995. Toward a better definition of the restless legs syndrome. The international restless legs syndrome study Group. Mov. Disord. 10, 634-642.
There are 23 citations in total.

Details

Primary Language English
Journal Section Internal Medical Sciences
Authors

Esra Yancar Demir

Tuba Özcan

Feriha Özer This is me

Bilge Aşkan Parlakoğlu This is me

Özgür Enginyurt

Soner Çankaya This is me

Publication Date January 30, 2015
Submission Date September 18, 2014
Published in Issue Year 2014 Volume: 31 Issue: 4

Cite

APA Yancar Demir, E., Özcan, T., Özer, F., Aşkan Parlakoğlu, B., et al. (2015). Restless legs syndrome and depression-anxiety disorder association in iron deficiency anemia patients. Journal of Experimental and Clinical Medicine, 31(4). https://doi.org/10.5835/jecm.omu.31.04.005
AMA Yancar Demir E, Özcan T, Özer F, Aşkan Parlakoğlu B, Enginyurt Ö, Çankaya S. Restless legs syndrome and depression-anxiety disorder association in iron deficiency anemia patients. J. Exp. Clin. Med. February 2015;31(4). doi:10.5835/jecm.omu.31.04.005
Chicago Yancar Demir, Esra, Tuba Özcan, Feriha Özer, Bilge Aşkan Parlakoğlu, Özgür Enginyurt, and Soner Çankaya. “Restless Legs Syndrome and Depression-Anxiety Disorder Association in Iron Deficiency Anemia Patients”. Journal of Experimental and Clinical Medicine 31, no. 4 (February 2015). https://doi.org/10.5835/jecm.omu.31.04.005.
EndNote Yancar Demir E, Özcan T, Özer F, Aşkan Parlakoğlu B, Enginyurt Ö, Çankaya S (February 1, 2015) Restless legs syndrome and depression-anxiety disorder association in iron deficiency anemia patients. Journal of Experimental and Clinical Medicine 31 4
IEEE E. Yancar Demir, T. Özcan, F. Özer, B. Aşkan Parlakoğlu, Ö. Enginyurt, and S. Çankaya, “Restless legs syndrome and depression-anxiety disorder association in iron deficiency anemia patients”, J. Exp. Clin. Med., vol. 31, no. 4, 2015, doi: 10.5835/jecm.omu.31.04.005.
ISNAD Yancar Demir, Esra et al. “Restless Legs Syndrome and Depression-Anxiety Disorder Association in Iron Deficiency Anemia Patients”. Journal of Experimental and Clinical Medicine 31/4 (February 2015). https://doi.org/10.5835/jecm.omu.31.04.005.
JAMA Yancar Demir E, Özcan T, Özer F, Aşkan Parlakoğlu B, Enginyurt Ö, Çankaya S. Restless legs syndrome and depression-anxiety disorder association in iron deficiency anemia patients. J. Exp. Clin. Med. 2015;31. doi:10.5835/jecm.omu.31.04.005.
MLA Yancar Demir, Esra et al. “Restless Legs Syndrome and Depression-Anxiety Disorder Association in Iron Deficiency Anemia Patients”. Journal of Experimental and Clinical Medicine, vol. 31, no. 4, 2015, doi:10.5835/jecm.omu.31.04.005.
Vancouver Yancar Demir E, Özcan T, Özer F, Aşkan Parlakoğlu B, Enginyurt Ö, Çankaya S. Restless legs syndrome and depression-anxiety disorder association in iron deficiency anemia patients. J. Exp. Clin. Med. 2015;31(4).