Early psychological aspects of severe hand injury.
We investigated the incidence and nature of psychological symptoms occurring during the first two months after severe hand injuries. 94% of patients had significant symptoms at some point early in rehabilitation, including nightmares (92%), flashbacks (88%), affective lability (84%), preoccupation with phantom limb sensations (13%), concentration/attention problems (12%), cosmetic concerns (10%), fear of death (5%), and denial of amputation (3%). Two months later, flashbacks (63%) remained pronounced. Nightmares (13%), affective lability (48%), concentration/attention problems (5%), fear of death (0%), and denial of amputation (0%) declined markedly, while cosmetic concerns (17%) and preoccupation with phantom limb sensations (17%) increased. Based on these findings, we believe that psychological treatment should often be given as part of the rehabilitation process.
Grunert
B K
BK
Froedtert Memorial Lutheran Hospital, Milwaukee, Wisconsin 53225.
Smith
C J
CJ
Devine
C A
CA
Fehring
B A
BA
Matloub
H S
HS
Sanger
J R
JR
Yousif
N J
NJ
D000342:Affective Symptoms / Q000209:etiology; D000673:Amputation, Traumatic / Q000523:psychology*; D004325:Dreams; D006230:Hand Injuries / Q000523:psychology*; D006801:Humans; D010591:Phantom Limb / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D013997:Time Factors