Psychological Distress in People with Lower Limb Amputation

Abstract

Background: Lower limb amputation frequently results in significant psychological distress, particularly depression, yet local data from Pakistan are scarce and global evidence regarding risk factors remains inconsistent. Objective: To determine the prevalence and risk factors of psychological distress, with a focus on depression, among adults with lower limb amputation, and to compare outcomes based on gender and amputation etiology. Methods: This crosssectional descriptive study was conducted at Fauji Foundation Hospital and allied hospitals of Rawalpindi Medical College, including 50 adults (25 males, 25 females) with lower limb amputation of traumatic or non-traumatic cause. Participants aged over 18 were selected by convenient sampling, assessed with the Hamilton Rating Scale for Depression (HAM-D), and categorized by gender and amputation etiology. Data were analyzed using SPSS v16, with chisquare testing, odds ratios, and confidence intervals reported; ethical approval was secured per the Helsinki Declaration. Results: Depression was observed in 62% of participants, with higher prevalence in females (72%) than males (52%) and in traumatic amputees (69.2%) compared to non-traumatic (54.2%). The odds ratio for depression in females was 2.52 (95% CI: 0.78–8.15; p=0.09) and for traumatic cause 1.98 (95% CI: 0.62–6.33; p=0.22), indicating trends but not statistically significant differences. Conclusion: Depression is highly prevalent after lower limb amputation, particularly among females and those with traumatic causes, highlighting the need for integrated psychological screening and intervention in amputee care to improve clinical outcomes.