STUDY OF POSTOPERATIVE PSYCHIATRIC DISORDERS IN PATIENTS OF AMPUTATION

Authors

  • Dr. Anupam Kakade Dept. Of General Surgery Datta Meghe Medical College, Shalinitai Meghe Hospital and Research Centre ( Author

DOI:

https://doi.org/10.61841/8vfc7b52

Keywords:

Psychiatric co morbidity,, amputation, posttraumatic stress disorder,, depression

Abstract

Amputation is emerging as a significant health strain on the health system, as well as on the families and community. Loss of limbs causes inability to sustain self and family which in many patients leads to different psychiatric disorders. The present research is therefore expected to investigate psychological comorbidity in amputated patients. Amputation of organ affects almost every aspect of a person's life. Psychological elements are important coping factors for the impairment.The study was collaborated with Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Sawangi (Meghe), Wardha, with Datta Meghe Medical College and Shalinitai Meghe Hospital and Research Centre, Hingna, Nagpur Maharashtra, in the Department of General Surgery in conjunction with Department Of Psychiatry. Over a period of 1 year 68 cases of amputation were studied whose surgery was done 6 months back. All participants were interviewed on a semistructured proforma of sociodemographic and amputationrelated parameters and assessed on psychiatric comorbidity using MiniInternational Neuropsychiatric Interview scale.All the patients were male and belonged to younger age group of 16–30 years 46 patients (67.64 %). Approximately, 66 patients had singlelimb amputation (97.05 %), predominantly right limb in 39 patients (57.35%). Road traffic accidents plays a major role in etiology of amputation followed by diabetic foot, peripheral vascular disease and electric burn injury. The most common psychiatric comorbidities in our sample were major depressive disorder in 48 patients (70.58%), suicidality in 08 patients (11.76%), and posttraumatic stress disorder (PTSD) in 12 patients (17.64%). PTSD was positively correlated with phantom sensation and phantom pain.A small number of amputees showed an troubling symptom of depression, suicidal thoughts and PTSD. Therefore, in order to control psychological comorbidity in amputees, liaison between surgical care providers and psychiatrists and psychologists must be established. We conclude that psychiatrist and psychologist play an important role in managing the cases of amputation in postoperative period along with surgeons.

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References

1. Kolb LC. Disturbances in Body Image: In Arielis. Reiser MF, eds: American Haodbook of Psychiatry, New York, Basic Books 1975; 4: 810-37.

2. Newell R. Body Image Disturbaoce; Cognitive Behavioral formulation and Intervention. Journal of Adv. Nurs 1991; 16:1400-5.

3. Kashani JH , Frank RG; Kashani SR, Wonderlich SA, Reid JC. Depression among amputees. Journal of Clinical Psychiatry1983; 44: 256-8.

4. Liliana EP, Timothy RD, Ellen 1M. Rehabilitation aod long tenn outcomes of persons with Trauma related amputations.Archives of Physical Medical Rehabilitation 2000; 81: 292-300.

5. FreietSOD RL, Lippmann SB. Psychiatric consultation for acute amputees. Psychosomatics 1987; 28: 183-9.

6. Friedmann LW. The Psychological Rehabilitation of the Amputee. Springfield Ill, Charles C Thomas Publishers 1978;17-67.

7. Parkes CM. Determinants of disablement after loss of a limb, in Krueger DW (ed): Emotional Rehabilitation of Physical Trauma and Disability. New York, SP Medical and Scientific Books 1984: 105-111.

8. Sherman RA, Sherman CJ, Bruno GM. Psychological factors influencing chronic phantom limb pain: An analysis of the literature. Pain 1987; 28: 285-95.

9. Sherman RA. Stump aod phaotom limb pain. Neurol Clin 1989; 7: 249-62.

10. Sahu A, Sagar R, Sarkar S, Sagar S. Psychological effects of amputation: A review of studies from India. Ind Psychiatry J 2016;25:4‑10.

11. Parkes CM. Components of the reaction to loss of a lamb, spouse or home. J Psychosom Res

1972;16:343‑9.

12. Kingdon D, Pearce T. Psychosocial assessment and management of amputee. In: Banarjee SN, editor. Rehabilitation of Management of the Amputees. Baltimore, MD: Williams Wilkins; 1982. p. 350-71.

13. Block WE, Ventur PA. A study of the psychoanalytic concept of castration anxiety in symbolically castrated amputees.Psychiatr Q 1963;37:518‑26.

14. Goldberg RT. New trends in the rehabilitation of lower extremity amputees. Rehabil Lit 1984;45:2‑11.

15. Pell JP, Donnan PT, Fowkes FG, Ruckley CV. Quality of life following lower limb amputation for peripheral arterial disease. Eur J Vasc Surg 1993;7:448‑51.

16. Sinha R, Van Den Heuvel WJ. A systematic literature review of quality of life in lower limb amputees.

Disabil Rehabil 2011;33:883‑99.

17. Durmus D, Safaz I, Adıgüzel E, Uran A, Sarısoy G, Goktepe AS, et al. The relationship between prosthesis use, phantom pain and psychiatric symptoms in male traumatic limb amputees. Compr Psychiatry 2015;59:45‑53.

18. Mckechnie PS, John A. Anxiety and depression following traumatic limb amputation: A systematic

review. Injury 2014;45:1859‑66.

19. Cavanagh SR, Shin LM, Karamouz N, Rauch SL. Psychiatric and emotional sequelae of surgical amputation. Psychosomatics 2006;47:459‑64.

20. Abeyasinghe NL, de Zoysa P, Bandara KM, Bartholameuz NA, Bandara JM. The prevalence of symptoms of post‑traumatic stress disorder among soldiers with amputation of a limb or spinal injury: A report from a rehabilitation centre in Sri Lanka. Psychol Health Med 2012;17:376‑81.

21. Margoob MA, Khan AY, Majid A, Mansur I, Gani N, Farooq M, et al. Prevalence of post traumatic stress disorder after amputation: A preliminary study from Kashmir. JK Pract 2008;15:5‑7.

22. Randall G, Ewalt J, Blair H. Psychiatric reaction to amputation. JAMA 1945;128:440‑6.

23. Shukla GD, Sahu SC, Tripathi RP, Gupta DK. Phantom limb: A phenomenological study. Br J Psychiatry 1982;141:54‑8.

24. Mansoor I, Margoob MA, Masoodi N, Mushtaq H, Younis T, Hussain A, et al. Prevalence of psychiatric co‑morbidities in traumatic amputees: A cross sectional study from Kashmir (Indian part). Br J Med Pract 2010;3:5.

25. Desmond DM, MacLachlan M. Coping strategies as predictors of psychosocial adaptation in a sample of elderly veterans with acquired lower limb amputations. Soc Sci Med 2006;62:208‑16.

26. Kamenchenko PV, Yastrebon VS, Tiganov AS. Psychiatric consequences of traumatic amputations. In:

Miller TW, editor.Clinical Disorders and Stressful Life Events. International Universities Press Stress and Health Series. No. 7. Madison,C.T: International Universities Press, Inc.; 1997.

27. Trivedi JK, Mall CP, Mishra US, Sharma VP, Dalal PK, Katiyar M, et al. Psychiatric sequelae of amputation: Ii long term effects. Indian J Psychiatry 1997;39:318‑23.

28. Sheehan DV,Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The mini‑international neuropsychiatric interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM‑IV and ICD‑10. J Clin Psychiatry 1998;59 Suppl 20:22‑33.

29. Jain, V., L. Waghmare, T. Shrivastav, and C. Mahakalkar. “SNAPPS Facilitates Clinical Reasoning in Outpatient Settings.” Education for Health: Change in Learning and Practice 31, no. 1 (2018): 59–60. https://doi.org/10.4103/1357-6283.239052.

30. Gupta K, Mahakalkar C, Kaple M, Deshpande S, Ladhha P, Jain N. A comparative study of cilostazol and pentoxifylline in intermittent claudication in peripheral arterial disease. J Datta Meghe Inst Med Sci Univ 2017;12:11-6.

31. Frank RG; Kashanji JH, Kashanji SR, Wonderleich SA, Reid SA, Umlauf RL et al. Psychological response to amputation as a function of age and time amputation. British lournal of Psychiatry 1984; 144: 493-7.

32. Bhise MC, Behere PB. Risk factors for farmers’ suicides in central rural India: Matched case–control psychological autopsy study. Indian J Psychol Med 2016;38:560-6.

33. Dr. Ranjit S. Ambad, Mr. Rakesh Kumar Jha, Dr. Nandkishor Bankar, Dr. Brij Raj Singh, Dr. Ajinkya S. Ghogare, Dr. Ragini Patil. ROLE OF PROLACTIN AND THYROID HORMONE IN PSYCHIATRIC

DISORDERS. International Journal of Psychosocial Rehabilitation, Vol. 24, Issue 06, 2020 page no 6001-6005.

34. Behere, P.B., K. Kumar, and A.P. Behere. “Depression: Why to Talk?” Indian Journal of Medical Research 145, no. April (2017): 411–13. https://doi.org/10.4103/ijmr. IJMR_295_17.

35. Atherton R, Robertson N.Psychological adjustment to lower limb amputation amongst prosthesis users. Disabil Rehabil 2006;28:1201‑9.

36. Phelps LF, Williams RM, Raichle KA, Turner AP, Ehde DM. The importance of cognitive processing to

adjustment in the 1st year following amputation. Rehabil Psychol 2008;53:28].

37. Asano M, Rushton P, Miller WC, Deathe BA. Predictors of quality of life among individuals who have a lower limb amputation. Prosthet Orthot Int 2008;32:231‑43.

38. Hanley MA, Jensen MP, Ehde DM, Hoffman AJ, Patterson DR, Robinson LR, et al. Psychosocial

predictors of long‑term adjustment to lower‑limb amputation and phantom limb pain. Disabil Rehabil 2004;26:882‑93.

39. Muzaffar N, Srinagar K. Psychiatric comorbidity in amputees with average sociodemographic status and the role of theologic and family support in a conflict zone. Australas J Disaster Trauma Stud 2012;1:31‑8.

40. Shukla GD, Sahu SC, Tripathi RP, Gupta DK. Phantom limb:A phenomenological study. Br J Psychiatry 1982;141:54‑8.

41. Fukunishi I, Sasaki K, Chishima Y, Anze M, Saijo M. Emotional disturbances in trauma patients during

the rehabilitation phase: Studies of posttraumatic stress disorder and alexithymia. Gen Hosp Psychiatry 1996;18:121‑7.

42. Mall CP, Trivedi JK, Mishra US, Sharma VP, Dalal PK, Katiyar M, et al. Psychiatric sequelae of

amputation:I immediate effects. Indian J Psychiatry 1997;39:313‑7.

43. Dunn DS. Well‑being following amputation: Salutary effects of positive meaning, optimism, and control. Rehabil Psychol 1996;41:285.

44. Washington J. The Relations among Psychological and Demographic Factors in Individuals with Lower Limb Amputation. Senior Theses, Trinity College, Hartford, CT 2013. Trinity College Digital Repository. Available from: http://www.digitalrepository.trincoll.edu/theses/337. Last accessed on 2015 Sep 10.

45. Hawamdeh ZM, Othman YS, Ibrahim AI. Assessment of anxiety and depression after lower limb amputation in Jordanian patients. Neuropsychiatr Dis Treat 2008;4:627‑33.

46. Gibson CA. Review of posttraumatic stress disorder and chronic pain: The path to integrated care. J Rehabil Res Dev 2012; 49:753‑76.

47. Dr. Ranjit S. Ambad, Roshan Kumar Jha, Dr. Nandkishor Bankar, Dr. Brij Raj Singh, Dr. Ajinkya S.

Ghogare, Dr. Ragini Patil. A CROSS-SECTIONAL COMPARISON OF SERUM HORMONE (FSH, TSH, GH) CONCENTRATIONS IN UNTREATED PATIENTS WITH PSYCHIATRIC DISORDER.

International Journal of Psychosocial Rehabilitation, Vol. 24, Issue 06, 2020 page no. 5960-5967.

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Published

30.06.2020

How to Cite

Kakade, D. A. (2020). STUDY OF POSTOPERATIVE PSYCHIATRIC DISORDERS IN PATIENTS OF AMPUTATION. International Journal of Psychosocial Rehabilitation, 24(6), 8375-8385. https://doi.org/10.61841/8vfc7b52