Suicidal ideation among individuals with dysvascular lower extremity amputation.

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OBJECTIVE: To examine the estimated prevalence and correlates of suicidal ideation (SI) among individuals 1 year after a first lower extremity amputation (LEA).

DESIGN: Cohort survey.

SETTING: Four medical centers.

PARTICIPANTS: 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.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: 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.

Medical Subject Headings

Activities of Daily Living; Aged; Aged, 80 and over; Amputation; Amputees; Comorbidity; Cross-Sectional Studies; Depression; Diabetes Complications; Female; Health Behavior; Health Status; Humans; Lower Extremity; Male; Middle Aged; Mobility Limitation; Peripheral Arterial Disease; Prevalence; Prospective Studies; Self Efficacy; Social Support; Suicidal Ideation

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Archives of physical medicine and rehabilitation







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