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Longitudinal Experience and Determinants for Common Mental Health Problems, Phantom Limb and Functional Outcome in Lower Limb Amputees

Indian J Orthop. 2023 Nov 7;57(12):2040-2049. doi: 10.1007/s43465-023-01007-0. eCollection 2023 Dec.

ABSTRACT

BACKGROUND: Amputation of a limb is equivalent to loss of a person’s life. Psychological aspects are essential factors in dealing with the disability and functional outcome is a significant concern. Longitudinal studies have not examined the experience and determinants of common mental health problems and functional outcome in lower limb amputees.

MATERIALS AND METHODOLOGY: A total of 103 lower limb amputees were recruited and followed up for 6 months. Patients were assessed on Hospital Anxiety and Depression Scale (HADS) and Social Functioning (SF-36) Quality of life, semi-structured clinical interview for psychiatric disorders and phantom limb at baseline (in hospital), at 2 weeks, 3 months and 6 months, respectively after discharge. Holistic care was provided through psychological counselling, supportive sessions, medications if required, rehabilitation counselling, prosthesis implantation, and treatment as usual.

RESULTS: Holistic care resulted in a statistically significant reduction in anxiety, depression and overall psychiatric morbidity as measured on HADS (p < 0.001). There was a significant improvement in all the domains of SF-36 (p -< 0.001) except the role of limitation due to physical activity. The intervention also resulted in a statistically significant reduction in the presence of phantom limbs.

CONCLUSION: Amputees should be provided holistic care under one roof, which was found to be very useful in treating psychiatric morbidity, social functioning and quality of life.

PMID:38009175 | PMC:PMC10673785 | DOI:10.1007/s43465-023-01007-0

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