A Prospective Longitudinal Study of Trajectories of Depressive Symptoms After Dysvascular Amputation.
Ann Marie Roepke, Aaron P Turner, Alison W Henderson and 4 others
PMID 30605638WHAT IT FOUND
After first major dysvascular lower-extremity amputation, average depressive symptoms decreased over the first 6 weeks, then remained stable to 12 months.
Prior anxiety or depression treatment and poorer self-rated health marked higher baseline symptoms.
Key findings
01Average PHQ-9 depression scores started at 8.30 and decreased by 1.69 points in the first 6 weeks, then changed by only 0.01 points between 6 weeks and 12 months.
02In the multivariable model, prior treatment for anxiety or depression and poorer self-rated health were linked to higher baseline PHQ-9 scores, while severe pain was not significant after adjustment.
03About 40% had at least moderate depressive symptoms at perioperative baseline, and about 23% did at 12 months.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample was mostly white, male, married or partnered Veterans, so it may not apply to women, civilians, younger people, or more diverse groups. Twenty of 141 died and 16 withdrew or were lost to follow-up; people who stayed longer contributed more information. Depressive symptoms, pain, and self-rated health were self-reported, which can introduce bias. The study did not measure mental health or rehabilitation treatments, so early improvement cannot be attributed to natural recovery, watchful waiting, or any specific intervention. Baseline assessment timing was imprecise because some participants were assessed before surgery and some after. The sample size may still have been too small to detect some relationships, including effects of amputation level or pain.
Declared interests
The supplied publication types indicate U.S. Government non-PHS research support. The article text provided does not include an explicit author conflict-of-interest declaration.
The easy way to misread this
Do not read the average 1.69-point drop in PHQ-9 scores during the first 6 weeks as proof that rehabilitation or watchful waiting improved mood. This was an observational cohort, and the paper did not measure which mental health or rehabilitation treatments patients received.