Baby Sojan, Chaudhury Suprakash, Walia Tejvir Singh
Department of Psychiatry, Command Hospital (Southern Command) and AFMC, Pune, Maharashtra, India.
Department of Psychiatry, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India.
Ind Psychiatry J. 2018 Jul-Dec;27(2):240-248. doi: 10.4103/ipj.ipj_69_18.
The sudden jolt of becoming an amputee brings with it the realization of loss of independence and self-built psychological and physical security. Advances in the field of prosthesis give the individual hope for better future, but the presence of psychological morbidity is a hurdle to be crossed in the road to satisfactory rehabilitation.
This study aimed to assess the psychiatric morbidity in amputees and the response to treatment.
One hundred newly amputated soldiers were assessed by means of clinical interview, General Health Questionnaire, Impact of Event Scale, Hospital Anxiety Depression Scale, McGill Pain Questionnaire, and Dallas Pain Questionnaire. Individuals were treated with appropriate medications and psychotherapy, and response to treatment was assessed.
Psychiatric disorders were diagnosed in 66% including adjustment disorders (40%), depressive episode (20%), and posttraumatic stress disorder (6%). Phantom sensation and phantom pain were noted in 72% and 64% of participants, respectively. More psychiatric disorders and phantom sensation were found in the early months after amputation. Psychiatric morbidity was associated with negative body image, distressing pain, and restriction of activities of daily life. Treatment produced complete remission of symptoms in 65.15% of individuals suffering from psychiatric disorders and statistically significant reduction in the scores of psychiatric rating scales.
There is a high prevalence of psychiatric morbidity among amputees. Psychiatric treatment produces significant improvement in the psychological well-being of amputees and underlines the need to focus on the psychological rehabilitations of the amputee apart from physical rehabilitation.
突然成为截肢者会让人意识到失去了独立性以及原本建立的心理和身体安全感。假肢领域的进展给患者带来了对更美好未来的希望，但心理疾病的存在是通往满意康复道路上需要跨越的障碍。
本研究旨在评估截肢者的精神疾病发病率以及对治疗的反应。
通过临床访谈、一般健康问卷、事件影响量表、医院焦虑抑郁量表、麦吉尔疼痛问卷和达拉斯疼痛问卷对100名新截肢的士兵进行评估。对个体进行适当的药物治疗和心理治疗，并评估治疗反应。
66%的患者被诊断患有精神疾病，包括适应障碍（40%）、抑郁发作（20%）和创伤后应激障碍（6%）。分别有72%和64%的参与者出现幻肢感觉和幻肢痛。截肢后的最初几个月发现更多的精神疾病和幻肢感觉。精神疾病与负面身体形象、疼痛困扰和日常生活活动受限有关。治疗使65.15%患有精神疾病的个体症状完全缓解，精神评定量表得分有统计学意义的降低。
截肢者中精神疾病的患病率很高。精神治疗能显著改善截肢者的心理健康，并强调除了身体康复外，还需要关注截肢者的心理康复。
