Evaluation of psychiatric problems among war-related bilateral upper limb amputees

Introduction. Amputation as a defect would result in personal disability which is widely affected by social and rehabilitative cares in case of insufficient social supports and services, it will finally lead to personal handicap.Material and Methods. During a focused 3 day program, of total 140 bilateral upper limb amputees, 103 patients were visited by an expert psychiatrist. Demographic data (sex, age, level and date of injury) along with comprehensive psychiatric examination (appearance, mood, affect, speech, perception, form and content of thought, memory, orientation …) were documented. Final diagnosis of patients’ psychiatric status and their functional score (0-100) were also recorded.Results. Except one, all of the visited amputees were men and had been injured 2.4 to 25.9 years before follow up (mean: 17.1 years). The mean age of the subjects at follow up was 37.5 y/o (15-82 y/o). 44.7% of the amputees reported a history of outpatient visit of a psychiatrist while 3 subjects had already been hospitalized due to psychiatric problems. Our visit revealed that 41.7% of the amputees had abnormal mood the most frequent was a depressive one (29.1%). Limited affect found in 16.3% and short term memory impairment reported in 45.6%. Axis I of psychiatric status examination showed that 50.5% of bilateral upper limb amputees suffer from psychiatric problems including mood disorders (33.9%) and anxiety disorders (30.1%). 42.5% of the patients had a functional score more than 90. Statistical analysis showed no relation between psychiatric disorders and level of amputation (p> 0.05).Conclusion. Depression and anxiety, as a reflection of their interpersonal problem and physical disabilities, may lead to social isolation and handicap of bilateral upper imb mputees. A well organized psychiatric and social support is strongly recommended.