Depression, social phobia and quality of life after major lower limb amputation

Abstract

Introduction: In this study, we aimed to compare the social phobia, depression and quality of life in patients with major lower limb amputation to non-amputated. Methods: Patients who were underwent above or below the knee amputation in the past were evaluated retrospectively by examining the hospital records. All the participants were administered Liebowitz Social Anxiety Scale (LSAS), Hospital Anxiety and Depression Scale (HADS), and Short-Form 36 (SF-36). Results: The number of patients was 30 (21 males, nine females) in the amputated group and 30 (22 males, eight females) in the control group. The mean age was 41.8±14.09 years in the amputated group and 43.3±18.68 years in the control group. All LSAS and HADS scores were higher, and SF-36 scores were lower in the amputation group compared to the control group (p<0.05). The patients who were amputated more than five years ago had higher LSAS social fear scores, and lower HAD depression scores compared to patients less than five years (p=0.035, p=0.024, respectively). The employed patients had lower HAD depression and HAD total scores compared to unemployed patients (p=0.008, p=0,049, respectively). The patients amputated due to medical complications had higher scores in anxiety compared to the patients with traumatic amputation (p=0.005, p=0.016, respectively). Discussion and Conclusion: Social phobia, depression and poor quality of life are common problems in patients with major lower limb amputation. After five years, it should not be forgotten that social phobia will increase; depression will decrease along with its seriousness. Therefore, amputated patients should be psychiatrically counseled and treated. It is important to provide permanent employment opportunities to improve the quality of life.

Anxiety and Depressive Symptoms in Moroccan Patients Following Major Lower Limb Amputation: A Three-Month Follow-Up

“…Regarding the impact of the amputation level on anxiety and depression, the study showed that amputation at the trans-femoral level presents a greater risk of having anxiety symptoms and depression than at the transtibial level. This result agrees with the study of Tutak et al [ 11 ]. In this sense, an Iranian study carried out on veterans who had undergone a unilateral transfemoral amputation showed that depression (32% confirmed depressed and 26% suspected) and anxiety (31% confirmed and 28% suspected) have a high prevalence among participants [ 29 ].…”

“…However, a Brazilian study reported a prevalence of around 68.5% [ 24 ]. In general, the prevalence of symptoms of anxiety and depression after MLLA gradually decreases, whether at three months [ 18 ], six months [ 21 ], or one year and more [ 11 , 14 , 21 , 25 - 27 ]. This reduction can be explained by the relief of pain, and the absence of fear and worry after the MLLA.…”

“…The HADS has been reported to have high internal consistency (Cronbach's alpha; HADS-D: 0.67-0.90, HADS-A: 0.68-0.93) [ 19 ]. The HADS scale has been used extensively in studies of people who have undergone amputation [ 11 , 20 - 23 ]. An Arabic version was utilized to determine the presence of anxiety and depression symptoms, with good internal consistency and reliability (Cronbach's alpha of 0.87 for the anxiety subscale and 0.84 for the depression subscale) [ 24 ].…”

“…Anxiety and depression harm the quality of life of amputees. This is dependent on factors such as age, gender, social support [ 16 ], coping ability [ 17 ], pain [ 18 ], and the cause and level of amputation [ 11 ].…”