title: Mental health outcome of unilateral lower limb amputee soldiers in two districts of Sri Lanka.
abstract: BACKGROUND
  Thousands of armed forces personnel in Sri Lanka have undergone lower limb amputations due to war injuries.
  
  
  OBJECTIVE
  The aims were to describe the mental health outcome of unilateral lower limb amputee male soldiers of the Sri Lanka Army in comparison with nonamputee males and to identify factors affecting the mental health outcome.
  
  
  METHODS
  Selected amputee soldiers (n = 461) and controls (n = 461) were evaluated for psychological distress using self-administered versions of GHQ-30 and BSI. Alcohol and drug consumption patterns were compared. Probable addiction to alcohol and drugs were assessed using the CAGE questionnaire.
  
  
  RESULTS
  A majority were below-knee amputees (413, 89.6%). Among amputee soldiers 36% were found to be psychologically distressed according to GHQ-30 while 13.4% were found to be psychologically distressed using BSI. Psychological distress was greater among amputee soldiers compared to controls (p < 0.001). Alcohol consumption and substance abuse were more common among amputees (p < 0.05), as was probable addiction to alcohol (p < 0.001). Being less than 30 years of age (OR =1.6, 95% CI (1.12-2.26)) was a factor influencing presence of psychological distress, characterized by psychological symptoms. Employment in the army adversely influenced psychological distress, characterized by psychological symptoms (OR = 2.35, 95% CI (2.0-3.64)) and by somatic symptoms (OR = 1.8, 95% CI (1.23-3.14)).
  
  
  CONCLUSIONS
  The study concluded that amputees have a comparatively poor mental health outcome, which could be improved by modifying some associated factors.
authors.affiliation: Department of Community Medicine, Faculty of Medicine, University of Colombo, Sri Lanka. nalikaguna@hotmail.com
authors.forename: Nalika
authors.initials: N
authors.lastname: Gunawardena
authors.forename: Rohini de A
authors.initials: Rde A
authors.lastname: Senevirathne
authors.forename: Thamara
authors.initials: T
authors.lastname: Athauda
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D000674:Amputees / Q000523:psychology* / Q000706:statistics & numerical data; D002321:Career Choice; D003130:Combat Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D006801:Humans; D007588:Job Satisfaction; D008297:Male; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data*; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D013188:Sri Lanka; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology