Affective distress and amputation-related pain among older men with long-term, traumatic limb amputations.

Psychological distress and postamputation pain were investigated in a sample of 582 males with long-term limb amputations (mean time since amputation 639.3 months, standard deviation 166.1; range 240-784 months). Prevalence of significant depressive symptoms (Hospital Anxiety and Depression Scale [HADS]-D score > or = 8) was 32.0%, and 34.0% of respondents met the screening criterion for clinical anxiety (HADS-A score > or = 8). Nearly one quarter (24.6%) of respondents reported significant post-traumatic psychological stress symptoms (Impact of Event Scale scores > or = 35). In total, 87.8% experienced either phantom or residual limb pain. Affective distress scores differed according to the respondents' type of pain experience. Respondents who experienced residual limb pain reported significantly higher affective distress scores than those with no phantom or residual limb pain. Many older individuals with long-term traumatic limb amputations could benefit from interventions to ameliorate affective distress and appropriate residual limb pain treatment.

[1]  Richard Schulz,et al.  Social and psychological factors in adjustment to limb amputation. , 1994 .

[2]  O. Horgan,et al.  Psychosocial adjustment to lower-limb amputation: A review , 2004, Disability and rehabilitation.

[3]  A. Harvey,et al.  Chronic pain and posttraumatic stress disorder: mutual maintenance? , 2001, Clinical psychology review.

[4]  R. Schulz,et al.  Social discomfort and depression in a sample of adults with leg amputations. , 1992, Archives of physical medicine and rehabilitation.

[5]  G. J. Asmundson,et al.  Posttraumatic stress disorder and work-related injury. , 1998, Journal of anxiety disorders.

[6]  J. Twisk,et al.  Longitudinal relationship between pain and depression in older adults: sex, age and physical disability , 2002, Social Psychiatry and Psychiatric Epidemiology.

[7]  John Rollins,et al.  Convergent validity of measures of Post-Traumatic Stress Disorder in a mixed military and civilian population , 1994, Journal of traumatic stress.

[8]  B. Rybarczyk,et al.  Body image, perceived social stigma, and the prediction of psychosocial adjustment to leg amputation. , 1995 .

[9]  M. Maclachlan,et al.  Psychosocial Perspectives on Postamputation Rehabilitation: A Review of Disease, Trauma, and War Related Literature , 2004 .

[10]  R. Melzack,et al.  Pain ‘memories’ in phantom limbs: review and clinical observations , 1990, Pain.

[11]  B. Engdahl,et al.  Assessment of Posttraumatic Stress Disorder in World War II Veterans. , 1996 .

[12]  Jan H B Geertzen,et al.  Phantom pain and health-related quality of life in lower limb amputees. , 2002, Journal of pain and symptom management.

[13]  K. Campbell,et al.  Pain site and impairment in individuals with amputation pain. , 2002, Archives of physical medicine and rehabilitation.

[14]  C. Crombie,et al.  Normative data for the HADS from a large non-clinical sample. , 2001, The British journal of clinical psychology.

[15]  P. Olin,et al.  Phantom pain, anxiety, depression, and their relation in consecutive patients with amputated limbs: case reports , 1998 .

[16]  A. Ateşalp,et al.  Depression in men with traumatic lower part amputation: a comparison to men with surgical lower part amputation. , 2003, Military medicine.

[17]  Malcolm MacLachlan,et al.  Development and psychometric evaluation of the Trinity Amputation and Prosthesis Experience Scales (TAPES). , 2000 .

[18]  H. Flor,et al.  The relationship of phantom limb pain to other phantom limb phenomena in upper extremity amputees 1 This work was supported by the Deutsche Forschungsgemeinschaft (Research Group `Clinical Psychophysiology of Pain', Bi 195/24). 1 , 1997, PAIN.

[19]  M. Maclachlan,et al.  Coping strategies as predictors of psychosocial adaptation in a sample of elderly veterans with acquired lower limb amputations. , 2006, Social science & medicine.

[20]  J. Czerniecki,et al.  Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation. , 2000, Archives of physical medicine and rehabilitation.

[21]  P. Dijkstra,et al.  Phantom pain and phantom sensations in upper limb amputees: an epidemiological study , 2000, Pain.

[22]  M. Maclachlan,et al.  Phantom limb pain and residual limb pain following lower limb amputation: a descriptive analysis. , 2001, Disability and rehabilitation.

[23]  P. Dougherty,et al.  Long-term follow-up of unilateral transfemoral amputees from the Vietnam war. , 2003, The Journal of trauma.

[24]  S. Wonderlich,et al.  Psychological Response to Amputation as a Function of Age and Time Since Amputation , 1984, British Journal of Psychiatry.

[25]  P. Taylor,et al.  Success rates for rehabilitation of vascular amputees: Implications for preoperative assessment and amputation level , 1992, The British journal of surgery.

[26]  B. Rybarczyk,et al.  The role of perceived vulnerability in adjustment to lower extremity amputation: A preliminary investigation. , 2002 .

[27]  M. Horowitz,et al.  Impact of Event Scale: A Measure of Subjective Stress , 1979, Psychosomatic medicine.

[28]  R A Sherman,et al.  Utilization of prostheses among US veterans with traumatic amputation: a pilot survey. , 1999, Journal of rehabilitation research and development.

[29]  E J MacKenzie,et al.  Incidence, acute care length of stay, and discharge to rehabilitation of traumatic amputee patients: an epidemiologic study. , 1998, Archives of physical medicine and rehabilitation.

[30]  E J MacKenzie,et al.  Rehabilitation and the long-term outcomes of persons with trauma-related amputations. , 2000, Archives of physical medicine and rehabilitation.

[31]  R. Snaith,et al.  The hospital anxiety and depression scale. , 2013, Acta psychiatrica Scandinavica.

[32]  M. Von Korff,et al.  The Relationship Between Pain and Depression , 1996, British Journal of Psychiatry.

[33]  T. Wohlfarth,et al.  Screening for Posttraumatic Stress Disorder: an evaluation of two self-report scales among crime victims. , 2003, Psychological assessment.

[34]  R. Sherman,et al.  Prevalence and characteristics of chronic phantom limb pain among American veterans. Results of a trial survey. , 1983, American journal of physical medicine.

[35]  Phantom Pain and Sensation Among British Veteran Amputees , 1998 .

[36]  C. Herrmann.  International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. , 1997, Journal of psychosomatic research.

[37]  A S Whyte,et al.  Psychological distress in amputees with phantom limb pain. , 2001, Journal of pain and symptom management.