Anxiety and/or depression: which symptoms contribute to adverse clinical outcomes after amputation?
Susana Pedras1, Luís Meira-Machado2, André Couto de Carvalho3
1School of Psychology, University of Minho, Braga, Portugal.
Background:
One of the most serious complications of diabetes mellitus (DM) is a diabetic foot ulcer (DFU), with lower extremity amputation (LEA).
Aims:
This study aims to explore the role of anxiety and depression on mortality, reamputation and healing, after a LEA due to DFU.
Methods:
A sample of 149 patients with DFU who underwent LEA answered the Hospital Anxiety and Depression Scale and a sociodemographic and clinical questionnaire. This is a longitudinal and multicenter study with four assessment moments that used Cox proportional hazards models adjusted for demographic and clinical variables.
Results:
Rate of mortality, reamputation and healing, 10 months after LEA were 9.4%, 27.5% and 61.7%, respectively. Anxiety, at baseline, was negatively associated with healing. However, depression was not an independent predictor of mortality. None of the psychological factors was associated with reamputation.
Conclusion:
Results highlight the significant contribution of anxiety symptoms at pre-surgery, to healing after a LEA. Suggestions for psychological interventions are made.
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