Assessment of anxiety and depression after lower limb amputation in Jordanian patients

Ziad M Hawamdeh¹, Yasmin S Othman², Alaa I Ibrahim³

¹Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Jordan, Amman, Jordan; ²Department of Orthotics and Prosthetics, Faculty of Rehabilitation Sciences, University of Jordan, Amman, Jordan; ³Lecturer, Department of Physical Therapy for Pediatrics and Pediatric surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt

Objective: This study aimed to assess the prevalence of anxiety and depression among Jordanian lower limb amputees with different clinical characteristics and sociodemographic data (gender, marital status, social support, income, type and level of amputation, and occupation).

Methods: Participants were 56 patients with unilateral lower limb amputation with mean duration (8.4 ± 5.75 years). They were recruited from inpatient and outpatient clinics of Jordan University hospital, Royal Farah Rehabilitation Center, and Al-basheer hospital in Amman, Jordan. Participants responded to a questionnaire that included a battery of questions requesting brief information about sociodemographic variables and characteristics of amputation. The level of depression and anxiety in each participating patient was assessed by the Hospital Anxiety and Depression Scale (HADS).

Results: The prevalence of anxiety and depressive symptoms were 37% and 20%, respectively. Factors associated with high prevalence of psychological symptoms included female gender, lack of social support, unemployment, traumatic amputation, shorter time since amputation, and amputation below the knee. These findings were confirmed by a significant reduction of anxiety and depression scores in patients who received social support, patients with amputation due to disease, and patients with amputation above the knee. Presence of pain and use of prosthesis had no effect on the prevalence.

Conclusions: The findings of the present study highlight the high incidence of psychiatric disability and depression in amputees; it also showed the importance of sociodemographic factors in psychological adjustment to amputation. It is suggested that psychiatric evaluation and adequate rehabilitation should form a part of their overall management.

Keywords: amputees, depression; anxiety, rehabilitation