title: Anxiety and depression in patients with amputated limbs suffering from phantom pain: a comparative study with non-phantom chronic pain.
abstract: BACKGROUND
  Phantom limb pain (PLP) is approximately a common condition after limb amputation, which potentially affects the quality of life. We aimed to evaluate anxiety and depression in patients with amputated limbs suffering from PLP and to compare these psychological dysfunctions with that of patients with non-phantom chronic pain.
  
  
  METHODS
  A total number of 16 male amputees with PLP and 24 male age-matched patients with non-phantom chronic pain were recruited in this study, which was performed at Khatam-Al-Anbia Pain Clinic, Tehran, Iran. A validated Persian version of the hospital anxiety and depression scale (HADS) was used to compare two psychological dysfunctions - anxiety and depression - between the two groups of study.
  
  
  RESULTS
  The mean of total anxiety score was significantly lower in patients with PLP (8.00 ± 3.93 vs. 11.25 ± 5.23; P = 0.041) and the prevalence of anxiety caseness (HADS-A score ≥ 11) was also lower in the PLP group (25% vs. 58.3%; P = 0.112, power = 31.7%). The mean of total depression score was 7.69 ± 5.51 and 9.38 ± 6.11 in patients of PLP and chronic pain groups, respectively (P = 0.340, power = 15%). Consequently, the prevalence of depression caseness (HADS-D score ≥ 11) was lower in PLP patients (37.5% vs. 50%; P = 0.710, power = 8%).
  
  
  CONCLUSIONS
  Our results indicate that depression and anxiety are not more common in PLP patients, whereas they are more prevalent in subjects with non-phantom chronic pain. These lower levels of anxiety and depression in PLP compared with chronic pain is a new finding that needs to be evaluated further, which may lead to new insights into the pathogenesis of phantom pain in further studies.
authors.affiliation: Department of Pediatrics, Khatam-Al-Anbia Hospital, Shefa Neuroscience Research Center, Shahed University of Medical Sciences, Tehran, Iran.
authors.forename: Hadi
authors.initials: H
authors.lastname: Kazemi
authors.forename: Shahin
authors.initials: S
authors.lastname: Ghassemi
authors.forename: Seyed Mohammad
authors.initials: SM
authors.lastname: Fereshtehnejad
authors.forename: Afshin
authors.initials: A
authors.lastname: Amini
authors.forename: Pier Hossein
authors.initials: PH
authors.lastname: Kolivand
authors.forename: Taher
authors.initials: T
authors.lastname: Doroudi
keywords: Anxiety; chronic pain; depression; hospital anxiety and depression scale; phantom limb pain
references.citation: J Psychosom Res. 1986;30(3):277-81
references.pmid: 3735170
references.citation: Dis Nerv Syst. 1966 Jul;27(7):441-50
references.pmid: 5942780
references.citation: J Pain Symptom Manage. 2006 Apr;31(4):362-8
references.pmid: 16632084
references.citation: EMBO Rep. 2002 Apr;3(4):288-91
references.pmid: 11943751
references.citation: Am J Clin Hypn. 1979 Apr;21(4):285-6
references.pmid: 474456
references.citation: Pain. 1994 Mar;56(3):289-297
references.pmid: 8022622
references.citation: Disabil Rehabil. 2004 Jul 22-Aug 5;26(14-15):837-50
references.pmid: 15497913
references.citation: Ann Acad Med Singap. 1994 Mar;23(2):129-38
references.pmid: 8080219
references.citation: Pain Physician. 2004 Jul;7(3):365-75
references.pmid: 16858476
references.citation: J Psychosom Res. 1973 Mar;17(2):97-108
references.pmid: 4741689
references.citation: Pain. 1979 Feb;6(1):47-55
references.pmid: 370738
references.citation: Am J Phys Med. 1983 Oct;62(5):227-38
references.pmid: 6624883
references.citation: Pain. 2000 Jul;87(1):33-41
references.pmid: 10863043
references.citation: Acta Chir Scand. 1954 May 5;107(2-3):158-62
references.pmid: 13188557
references.citation: Behav Res Ther. 1980;18(4):355-7
references.pmid: 7436982
references.citation: BMJ. 1998 Mar 21;316(7135):903-4
references.pmid: 9552839
references.citation: Pain. 1990 Dec;43(3):319-336
references.pmid: 2293143
references.citation: Appl Psychophysiol Biofeedback. 2001 Jun;26(2):141-6
references.pmid: 11480164
references.citation: Neurosurgery. 1987 Mar;20(3):496-500
references.pmid: 2883607
references.citation: Neuropsychiatr Dis Treat. 2008 Jun;4(3):627-33
references.pmid: 18830394
references.citation: Disabil Rehabil. 2006 Oct 15;28(19):1201-9
references.pmid: 17005481
references.citation: J Psychosom Res. 2002 Feb;52(2):69-77
references.pmid: 11832252
references.citation: Arch Gen Psychiatry. 1978 Nov;35(11):1304-11
references.pmid: 708194
references.citation: Mil Med. 2003 Feb;168(2):106-9
references.pmid: 12636136
references.citation: Acta Psychiatr Scand. 1983 Jun;67(6):361-70
references.pmid: 6880820
references.citation: Clin Rehabil. 2007 Aug;21(8):754-9
references.pmid: 17846075
references.citation: Pain. 2007 Dec 5;132(3):332-336
references.pmid: 17910905
references.citation: Clin Rehabil. 2002 Jun;16(4):368-77
references.pmid: 12061470
references.citation: J Pain Symptom Manage. 2002 Oct;24(4):429-36
references.pmid: 12505212
references.citation: J Psychosom Res. 2002 Oct;53(4):903-6
references.pmid: 12377301
references.citation: Health Qual Life Outcomes. 2003 Apr 28;1:14
references.pmid: 12816545
references.citation: Psychiatr Pol. 2006 Mar-Apr;40(2):335-45
references.pmid: 17037108
references.citation: Disabil Rehabil. 2002 May 20;24(8):416-22
references.pmid: 12033996
references.citation: Pain. 1985 Mar;21(3):267-278
references.pmid: 3991231
references.citation: Clin Rehabil. 2009 Mar;23(3):281-6
references.pmid: 19218302
references.citation: Br J Clin Psychol. 2001 Nov;40(4):429-34
references.pmid: 11760618
references.citation: Pain. 1983 Nov;17(3):243-256
references.pmid: 6657285
references.citation: Curr Rev Pain. 2000;4(2):166-70
references.pmid: 10998730