Evaluation of Early Psychological symptoms of Major Limb Amputation in a Tertiary Hospital

Abstract

Amputation may be used to treat a diseased limb or improve its function, and it is considered the last, albeit valuable option when limb salvage is impossible. The decision to amputate a limb is an emotional process for the patient and the patient's family. The result is often loss of economic power of the individual and his/her independence when not sufficiently rehabilitated back into the society. The aim of the study was to determine early psychological outcome of major limb amputation. This was a prospective study, where 54 consenting patients admitted via either the accident and emergency unit or general outpatient clinic of a tertiary hospital for major limb amputation that met the inclusion criteria were recruited into the study consecutively over a period of one year. They were assessed for depression with Mini International Neuropsychiatric Interview (MINI) Instrument, while Rehabilitation outcome was graded using functional independence measure. Intensive counseling with psycho education was commence before amputation and continues after amputation by counselors. Physiotherapy, occupational therapy, coping skills and other life skill training commence after amputation to 3 months of follow up. Only 1 (1.9%) of the respondents was diagnosed with major depressive episode out of the 54 that completed the study. Some of the remaining 53 (98.1%) had few symptoms of depression but did not fulfilled the diagnostic criteria for major depressive episode according to M.I.N.I. The rehabilitation of all the patients were good with a mean functional measure score of 117.59 (sd=3.328) and a P-value of 0.00 at discharge and even after follow up. Our findings show that early and proper rehabilitation of amputees seem to reduce their psychological symptoms. Tendency to get depressed following amputation is more common in the younger age group, female gender and in amputations as a result of trauma while rehabilitation seems better in same and vice versa.