Prevalence of Anxiety, Depression, and Post-traumatic Stress Disorder Among Amputees Attending Jaipur Foot Trust Artificial Limb Centre

Abstract

Background: Amputees have been noted to present with various psychiatric disorders including anxiety, body image disturbances, depression, and post-traumatic disorder (PTSD). However, there is limited data available on the prevalence of anxiety, depression, and PTSD among amputees in Kenya despite the high incidences of amputations in Kenyan hospitals. Purpose: This study aims to find out the prevalence of anxiety, depression, and post-traumatic stress disorder among amputees attending the Jaipur Foot Trust Center. Method: This study took a cross-sectional descriptive study design. One hundred and forty-one patients attending the Jaipur Foot Trust were recruited to participate in the study after giving informed consent. A socio-demographic questionnaire was used to collect socio-demographic characteristics in addition to level amputation and reason for amputation. The Patient Health Questionnaire (PHQ-9) was used to assess the patient's depression. The Generalized Anxiety Disorder (GAD-7) scale was used to assess the patient's anxiety level and The Impact of Event Scale (IES-R) was used to assess the severity of post-traumatic stress disorder (PTSD). Collected data were entered into MS-Access software and checked for errors before the commencement of data analysis using STATA software. For discrete variables, frequency tables, pie, and bar charts captured the distribution of data while for continuous variables, means and standard deviations were provided. At the bivariate level, correlation and chi-square were done to investigate the relationships between the study variables, and while at the multi-variate level, regression analysis was applied to provide adjusted odds ratios. The level of statistical significance was set at p<0.05. Results: Findings from this study showed alarming rates of psychiatric morbidity where two-thirds of the patients reported PTSD (65.2%) with more than three-quarters of patients being diagnosed with depression (89.4%) and anxiety (91.5%). Also, there was a significant correlation between depression, anxiety, and PTSD, such that participants who had higher scores on anxiety and depression had significantly higher PTSD scores and vice versa. Conclusion: Anxiety, Depression, and PTSD are very common psychological reactions in patients who have undergone amputation. The researcher expected that some of the sociodemographic factors and some amputation-related characteristics would have had a relation with psychiatric comorbidity, but the findings of this study did not show any such relationship except the relation between anxiety, depression, and PTSD. Recommendation: Early psychological assessment and interventions after amputations will help prevent psychological illnesses