BOSTON — Practitioners should screen for depressive symptoms in patients with lower limb loss to improve health and clinical outcomes, according to data presented at the American Orthotic and Prosthetic Association National Assembly, here.
J. Megan Sions, PhD, DPT, found that depression rates are three- to four-times higher in individuals with lower limb amputation when compared to the general population.
Following amputation, unmanaged depression can lead to suicidal ideation and decreased patient satisfaction, the data noted. Dyvascularity, diabetes or unsuccessful prosthetic fitting was significantly associated with increased depression, and at 12 months post-amputation, patients with a major depressive episode were found to walk fewer hours with their prostheses.
From September 2013 to January 2015, Sions and colleagues recruited patients from multidisciplinary clinics for evaluation to support a new prosthetic device or replacement of prosthetic componentry. Patients were included if they had a lower limb amputation of any level, regardless of etiology. All patients receive a standardized evaluation conducted by a licensed therapist, prosthetist and psychiatrist. Participants also completed a medical questionnaire checklist and listed all of their medications. The evaluation included screening for depressive symptoms using a two-item survey, detailing their history with depression.
According to the findings, “it is imperative to identify patients with depressive symptoms, so that these individuals can receive appropriate management.” Identification and management of depression may improve patient outcomes since depression is correlated to patient long-term satisfaction following limb loss, the data noted. – by Shawn M. Carter
Reference:
Sions JM. Importance of screening for depression among individuals with a lower limb amputation. Presented at: American Orthotic and Prosthetic Association National Assembly; Sept. 8-11, 2016; Boston.
Disclosure: Sions reports she is a consultant Independence Prosthetics-Orthotics Inc. The research was funded in part by an Orthotic and Prosthetic Education and Research Foundation grant.
