MORBID PSYCHIATRIC DISORDER IN PATIENTS OF AMPUTATION-A HOSPITAL BASED STUDY

Junaid Nabi*, Ajaz Ahmad Suhaff, Abdul Wahid Khan, Sajid Mohammad, Mir Himayun, Nowsheen Zaffar, Mohammad Sarwar Mir

ABSTRACT

Background: Amputation is the removal of one or more parts of the body and can be as a result of unprecedented havoc or natural disasters; like accidents, earthquakes of major intensity, terrorism and war, or carried out due to medical reasons with the motive to improve health outcomes and quality of life of patients. In cancer patients, it is performed as a lifesaving procedure to protect them from further malignancy of the body part or to other parts of the body. Irrespective of the cause of amputation, it brings a significant and drastic change in a person’s life, and one goes from a stage of shock, to acknowledgement, and finally adjustment. As compared to the upper limb amputees, the lower limb amputees experience more changes in their life after the amputation. A cross-sectional study reported vehicle accidents as the major cause of amputation. Individuals suffering from traumatic limb loss at any age are likely to suffer subsequent difficulties with their body image, but these relationships are more striking in the younger age groups who have experienced traumatic injuries. The psychological reactions to amputations are clearly diverse and range from severe disability at one extremes; determined and effective resumption of a full and active life at other end. In view of less number of studies in this field from Kashmir, increase number of patients referred to our hospital which is a tertiary care hospital and ongoing conflict which is there from past 27 years, we intended to take up this study to find out psychiatric co morbidities in these patients. Methods: Hundred successive patients presents with history of Amputation who fulfilled inclusion and exclusion criteria were taken up for the study and administered the Mini International Neuropsychiatric Interview (MINI) scale for evaluation of psychiatric co-morbidity. Each patient was informed about the purpose of interview; his/her consent was obtained and strict confidentiality was ensured. General description, demographic data and psychiatric history were recorded using semi structured Proforma and MINI. Results: Out of hundred cases of amputation, 61% of the patients were in the age group of 36-55 followed by 18% in age group of 16-35 years. This could suggest that amputation affects middle age group more. There were predominantly more males (67%) than females (33%) in our study. Representations of gender, occupation and marital status have been found to be in accordance with socio-demographic profile of our country. Out of hundred cases of amputation, indication for same was maximum with motor vehicle accidents (57%) followed by electrocution with 23%. Discussion: In our study, the most common psychiatric co-morbidity was Major Depressive Disorder(53%) followed by with Generalized Anxiety Disorder in 15% and Panic Disorder in 9%.

Keywords: Amputation, Quality of life, Major Depressive Disorder.