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The process of amputation is defined as the surgical removal of part of the body, such as an arm or leg. Traumatic amputations may be done when a limb cannot be salvaged after an accident or injury. Rehabilitation succeeding the operation is a crucial part of the entire recovery process, but assessing the patients’ mental health, such as anxiety and depression, is also extremely important. In traumatic amputations, patients grieve for a huge and sudden loss. Such a degree of abrupt disturbance may pose the patient at a higher risk of depression. Results from studies using the Hospital Anxiety and Depression Scale (HADS) were included.
To determine and compare the prevalence of depression between patients with upper and lower traumatic limb amputations.
A literature search of electronic databases including PubMed, Medline, Embase, Cochrane Library and CINAHL was performed. Searches were included from January 2000 using the terms ‘amputation’, ‘depression’ and ‘HADS’.
Data from 889 participants was used and the mean age for all participants was 49.4 years. It was shown that HADS depression and anxiety scores are higher in traumatic upper limb amputations than in lower limb amputations. In upper limb amputations, the mean depression and anxiety scores were 5.30 ± 1.24 and 7.46 ± 1.30, respectively. In lower limb amputations, the mean depression and anxiety scores were 4.50 ± 0.28 and 5.73 ± 0.93, respectively.
Data shows slightly higher HADS depression and anxiety scores in traumatic upper limb amputations compared to lower limb amputations. However, factors such as the ratio of males to females in the study, socio-economic background of the participants, etc., should be taken into consideration as well. Nevertheless, psychological support is a crucial part of rehabilitation for post-traumatic amputees.
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McDonald CL, Westcott-McCoy S, Weaver MR, Haagsma J, Kartin D. Global prevalence of traumatic non-fatal limb amputation. Prosthet Orthot Int. 2021;45(2):105–14.
Stern AF. The hospital anxiety and depression scale. Occup Med (Lond). 2014;64(5):393–4.
Bhutani S, Bhutani J, Chhabra A, Uppal R. Living with amputation: Anxiety and depression correlates. Journal of Clinical and Diagnostic Research. 2016;10(9):RC09-RC12.
Desteli EE, İmren Y, Erdoğan M, Sarısoy G, Coşgun S. Comparison of upper limb amputees and lower limb amputees: a psychosocial perspective. Eur J Trauma Emerg Surg. 2014;40(6):735-9.
Desmond DM. Coping, affective distress, and psychosocial adjustment among people with traumatic upper limb amputations. J Psychosom Res. 2007;62(1):15-21.
Desmond DM, MacLachlan M. Affective distress and amputation-related pain among older men with long-term, traumatic limb amputations. Journal of Pain & Symptom Management. 2006;31(4):362-8.
Hawamdeh ZM, Othman YS, Ibrahim AI. Assessment of anxiety and depression after lower limb amputation in Jordanian patients. Neuropsychiatr Dis Treat. 2008;4(3):627-33.
Mckechnie PS, John A. Anxiety and depression following traumatic limb amputation: a systematic review. Injury. 2014;45(12):1859–66.
Albert PR. Why is depression more prevalent in women? J Psychiatry Neurosci. 2015;40(4):219–21.