title: Depression and anxiety symptoms after lower limb amputation: the rise and fall.
abstract: OBJECTIVE
  To examine the time course of anxiety and depressive symptoms over a three year period after amputation.
  
  
  METHODS
  A prospective study in inpatients admitted to a rehabilitation ward after lower limb amputation.
  
  
  METHODS
  Successive admissions over a one-year period of whom 68 were alive at follow-up, 2-3 years later.
  
  
  METHODS
  Nil.
  
  
  METHODS
  Hospital Anxiety and Depression Scale (HADS) on admission and discharge from inpatient rehabilitation and at a 2.7(SD=0.4) year mean follow-up period with correlation to demographic and patient features.
  
  
  RESULTS
  Of the 68 responding patients, 12 (17.6%) and 13 (19.1%) had symptoms of depression and anxiety respectively. This compared to an original incidence of 16 (23.5%) for both on admission and 2 (2.9%) on discharge. This rise in incidence from time of discharge was highly significant for both depression (P<0.001) and anxiety (P<0.001). Depression at follow-up was correlated to depressive symptoms at admission (P=0.03) and to having other significant comorbidities (P=0.02). Anxiety symptoms were commoner in younger patients (P=0.03). There was no association with age, gender, living in isolation, vascular cause for amputation, wearing a limb prosthesis or length of original inpatient stay.
  
  
  CONCLUSIONS
  Depression and anxiety are common after lower limb amputation but resolve during inpatient rehabilitation. The incidence then rises again after discharge.
authors.affiliation: Department of Neurorehabilitation, Northern General Hospital, Sheffield, UK. rajiv.singh@sth.nhs.uk
authors.forename: Rajiv
authors.initials: R
authors.lastname: Singh
authors.forename: David
authors.initials: D
authors.lastname: Ripley
authors.forename: Brian
authors.initials: B
authors.lastname: Pentland
authors.forename: Iain
authors.initials: I
authors.lastname: Todd
authors.forename: John
authors.initials: J
authors.lastname: Hunter
authors.forename: Lynne
authors.initials: L
authors.lastname: Hutton
authors.forename: Alistair
authors.initials: A
authors.lastname: Philip
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000523:psychology* / Q000534:rehabilitation*; D001008:Anxiety Disorders / Q000453:epidemiology*; D001186:Artificial Limbs; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007866:Leg; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors