title: Suicidal ideation among individuals with dysvascular lower extremity amputation.
abstract: OBJECTIVE
  To examine the estimated prevalence and correlates of suicidal ideation (SI) among individuals 1 year after a first lower extremity amputation (LEA).
  
  
  METHODS
  Cohort survey.
  
  
  METHODS
  Four medical centers.
  
  
  METHODS
  A referred sample of patients (N=239), primarily men, undergoing their first LEA because of complications of diabetes mellitus or peripheral arterial disease, were screened for participation between 2005 and 2008. Of these patients, 136 (57%) met study criteria and 87 (64%) enrolled; 70 (80.5%) of the enrolled patients had complete data regarding SI at 12-month follow-up.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  SI, demographic/health information, depressive symptoms, mobility, independence in activities of daily living (ADL), satisfaction with mobility and ADL, medical comorbidities, social support, self-efficacy.
  
  
  RESULTS
  At 12 months postamputation, 11 subjects (15.71%) reported SI; of these, 3 (27.3%) screened negative for depression. Lower mobility, lower satisfaction with mobility, greater impairment in ADL, lower satisfaction with ADL, lower self-efficacy, and depressive symptoms were all correlated with the presence of SI at a univariate level; of these, only depressive symptoms remained significantly associated with SI in a multivariable model.
  
  
  CONCLUSIONS
  SI was common among those with recent LEA. Several aspects of an amputee's clinical presentation, such as physical functioning, satisfaction with functioning, and self-efficacy, were associated with SI, although depression severity was the best risk marker. A subset of the sample endorsed SI in the absence of a positive depression screen. Brief screening for depression that includes assessment of SI is recommended.
authors.affiliation: Veterans Administration Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA. Electronic address: Aaron.Turner@va.gov.
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Turner
authors.affiliation: Veterans Administration Puget Sound Health Care System, Seattle, WA.
authors.forename: Tiffany M
authors.initials: TM
authors.lastname: Meites
authors.affiliation: Veterans Administration Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Rhonda M
authors.initials: RM
authors.lastname: Williams
authors.affiliation: Veterans Administration Puget Sound Health Care System, Seattle, WA.
authors.forename: Alison W
authors.initials: AW
authors.lastname: Henderson
authors.affiliation: Spectrum Research, Inc, Tacoma, WA.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Norvell
authors.affiliation: Veterans Administration Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Kevin N
authors.initials: KN
authors.lastname: Hakimi
authors.affiliation: Veterans Administration Puget Sound Health Care System, Seattle, WA; Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Czerniecki
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000523:psychology* / Q000534:rehabilitation*; D000674:Amputees / Q000523:psychology* / Q000534:rehabilitation*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D048909:Diabetes Complications; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D058729:Peripheral Arterial Disease / Q000150:complications; D015995:Prevalence; D011446:Prospective Studies; D020377:Self Efficacy; D012944:Social Support; D059020:Suicidal Ideation
keywords: Amputation; Depression; Rehabilitation; Suicidal ideation