Reazioni psicologiche in soggetti con amputazione di arto: una rassegna della letteratura

Titolo Rivista PSICOLOGIA DELLA SALUTE
Autori/Curatori Martina Luchetti, Andrea Giovanni Cutti, Ornella Montebarocci, Gennaro Verni, Nicolino Cesare Franco Rossi
Anno di pubblicazione 2013 Fascicolo 2013/1
Lingua Italiano Numero pagine 22 P. 49-70 Dimensione file 329 KB
DOI 10.3280/PDS2013-001003
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L’obiettivo di questo lavoro è fornire un quadro aggiornato sull’attuale stato delle conoscenze relative all’adattamento psicologico post-amputazione, fornendo un’analisi critica degli aspetti metodologici e illustrando alcuni strumenti specificatamente allestiti per indagare le problematiche psicosociali dei soggetti amputati. I risultati delle ricerche evidenziano la presenza di sintomi ansioso-depressivi significativi nel breve periodo dopo il trauma, così come a distanza di numerosi anni. Tuttavia, restano poco indagate alcune fasi potenzialmente critiche, come il periodo immediatamente successivo alla dimissione dai centri di riabilitazione in cui il supporto delle terapie si riduce. Data la complessità del processo di adattamento alla perdita di un arto, diversi autori hanno sottolineato la necessità di ulteriori studi longitudinali, al fine di esplorare l’evoluzione delle reazioni psicologiche nelle diverse fasi del percorso riabilitativo/protesico, nel breve e lungo periodo post-amputazione. Considerare aspetti di natura psicosociale, oltre che medico-riabilitativa, è di rilevanza centrale sia per la ricerca che per la pratica clinica.;

Keywords:Amputazione di arto, adattamento, ansia, depressione, disturbo posttraumatico da stress.

  1. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author
  2. Asano M., Rushton P., Miller W.C. and Deathe B.A. (2008). Predictors of quality of life among individuals who have a lower limb amputation. Prosthetics and Orthotics International, 32 (2): 231-243. DOI: 10.1080/03093640802024955
  3. Atherton R. and Robertson N. (2006). Psychological adjustment to lower limb amputation amongst prosthesis users. Disability & Rehabilitation, 28 (19): 1201-1209. DOI: 10.1080/09638280600551674
  4. Baldassarri F., a cura di (2004). Analisi e valutazione delle caratteristiche di personalità in pazienti amputati di arto, attraverso la somministrazione di una batteria di test psicologici. [Analysis and evaluation of personality traits in limb amputee patients, using psychological tests]. Budrio: Centro Protesi INAIL
  5. Bonanno G.A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59 (1): 20-28. DOI: 10.1037/0003-066X.59.1.20
  6. Bonanno G.A., Ho S.M., Chan J.C., Kwong R.S., Cheung C.K. and Wong C.P. (2008). Psychological resilience and dysfunction among hospitalized survivors of the SARS epidemic in Hong Kong: a latent class approach. Health Psychology, 27 (5): 659-667. DOI: 10.1037/0278-6133.27.5.659
  7. Bhuvaneswar C.G., Epstein L.A. and Stern T.A. (2007). Reactions to amputation: recognition and treatment prim care companion The Journal of Clinical Psychiatry, 9 (4): 303-308
  8. Burger H., Franchignoni F., Heinemann A.H., Kotnik S. and Giordano A. (2008). Validation of the Orthotics and Prosthetics User Survey Upper Extremity functional status module in people with unilateral upper limb amputation. Journal of Rehabilitation Medicine, 40 (5): 393-399. DOI: 10.2340/16501977-0183
  9. Cansever A., Uzun O., Yildiz C., Ates A. and Atesalp A.S. (2003). Depression in men with traumatic lower part amputation: a comparison to men with surgical lower part amputation. Military Medicine, 168 (2): 106-110
  10. Cavanagh S.R., Shin L.M., Karamouz N. and Rauch S.L. (2006). Psychiatric and emotional sequelae of surgical amputation. Psychosomatics, 47 (6): 459-464. DOI: 10.1176/appi.psy.47.6.459
  11. Cheung E., Alvaro R. and Colotla V.A. (2003). Psychological distress in workers with traumatic upper- or lower-limb amputations following industrial injuries. Rehabilitation Psychology, 48 (2): 109-112. DOI: 10.1037/0090-5550.48.2.109
  12. Coffey L., Gallagher P., Horgan O., Desmond D. and MacLachlan M. (2009). Psychosocial adjustment to diabetes-related lower limb amputation. Diabetic Medicine, 26, (10): 1063-1067. DOI: 10.1111/j.1464-5491.2009.02802.x
  13. Copuroglu C., Ozcan M., Yilmaz B., Gorgulu Y., Abay E. and Yalniz E. (2010). Acute stress disorder and post-traumatic stress disorder following traumatic amputation. Acta Orthopaedica Belgica, 76 (1): 90-93.
  14. Couture M., Desrosiers J. and Caron C. (2011). Cognitive appraisal and perceived benefits of dysvascular lower limb amputation: a longitudinal study. Archives of Gerontology and Geriatrics, 52 (1): 5-11. DOI: 10.1016/j.archger.2009.11.002
  15. Damiani C. (2008). Studio dell’impatto riabilitativo dell’alterata percezione dell’immagine corporea nel paziente amputato agli arti inferiori. [Study of the impact rehabilitation of altered perception of body image in patients with limb amputation]. European Journal of Physical and Rehabilitation Medicine, Suppl.1 to No.3.
  16. Darnall B.D., Ephraim P., Wegener S.T., Dillingham T., Pezzin L., Rossbach P., Ellen J. and MacKenzie E.J. (2005). Depressive symptoms and mental health service utilization among person with limb loss: results of a national survey. Archives of Physical Medicine and Rehabilitation, 86 (4): 650-658. DOI: 10.1016/j.apmr.2004.10.028
  17. Datta D., Selvarajah K. and Davey N. (2004). Functional outcome of patients with proximal upper limb deficiency – acquired and congenital. Clinical Rehabilitation, 18: 172-177. DOI: 10.1191/0269215504cr716oa
  18. DeRoon-Cassini T.A., Mancini A.D., Rusch M.D. and Bonanno G.A. (2010). Psychopathology and resilience following traumatic injury: a latent growth mixture model analysis. Rehabilitation Psychology, 55 (1): 1-11. DOI: 10.1037/a0018601
  19. Deshields T., Tibbs T., Fan M.Y. and Taylor M. (2006). Differences in patterns of depression after treatment for breast cancer. Psycho-Oncology, 15 (5): 398-406. DOI: 10.1002/pon.962
  20. Desmond D.M. (2007). Coping, affective distress, and psychosocial adjustment among people with traumatic upper limb amputations. Journal of Psychosomatic Research, 62 (1): 15-21. DOI: 10.1016/j.jpsychores.2006.07.027
  21. Desmond D.M. and MacLachlan M. (2002). Psychological issues in prosthetic and orthotic practice: a 25 year review of psychology in Prosthetics and Orthotics International. Prosthetics and Orthotics International, 26 (3): 182-188. DOI: 10.1080/03093640208726646
  22. Desmond D.M. and MacLachlan M. (2004). Psychosocial perspectives on post-amputation rehabilitation: a review of disease, trauma and war related literature. Critical Reviews in Physical and Rehabilitation Medicine, 16 (2): 77-93. DOI: 10.1615/CritRevPhysRehabil Med.v16.i2.10
  23. Desmond D.M. and MacLachlan M. (2005). Factor structure of the Trinity Amputation and Prosthesis Experience scales (TAPES) with individuals with acquired upper limb amputations. American Journal of Physical Medicine & Rehabilitation, 84 (7): 506-513. DOI: 10.1097/01.phm.0000166885.16180.63
  24. Desmond D.M. and MacLachlan M. (2006a). Affective distress and amputation-related pain among older men with long-term, traumatic limb amputation. Journal of Pain and Symptom Management, 31 (4): 362-368. DOI: 10.1016/j.jpainsymman.2005.08.014
  25. Desmond D.M. and MacLachlan M. (2006b). Coping strategies as predictors of psychosocial adaptation in a sample of elderly veterans with acquired lower limb amputations. Social Science & Medicine, 62 (1): 208-216. DOI: 10.1016/j.socscimed.2005.05.011
  26. Ebrahimzadeh M.H. and Fattahi A.S. (2009). Long-term clinical outcomes of Iranian veterans with unilateral transfemoral amputation. Disability & Rehabilitation, 31 (22): 1873- 1877. DOI: 10.1080/09638280902810968
  27. Ebrahimzadeh M.H., Fattahi A.S. and Nejad A.B. (2006). Long-term follow-up of Iranian veteran upper extremity amputees from the Iran-Iraq war (1980-1988). Journal of Trauma, 61 (4): 886-888. DOI: 10.1097/01.ta.0000236014.78230.77
  28. Ebrahimzadeh M.H. and Rajabi M.T. (2007). Long-term outcomes of patients undergoing war-related amputations of the foot and ankle. Journal of Foot and Ankle Surgery, 46 (6): 429-433. DOI: 10.1053/j.jfas.2007.08.011
  29. Ferguson A.D., Richie B.S. and Gomez M.J. (2004). Psychological factors after traumatic amputation in landmine survivors: the bridge between physical healing and full recovery. Disability & Rehabilitation, 26 (14/15): 931-938. DOI: 10.1080/09638280410001708968
  30. First M.B., Spitzer R.L., Gibbon M. and Williams J.B.W. (2002). Structured Clinical Interview for DSM IV – TR Axis I Disorder, Research Version patient Edition (SCID-I/P). New York: Biometrics Research, State Psychiatric Institute
  31. Gallagher, P., Desmond, D. M., MacLachlan, M., editors, (2008). Psychoprosthetics: state of the knowledge. London: Springer-Verlag. DOI: 10.1007/978-1-84628-980-4
  32. Gallagher P., Franchignoni F., Giordano A. and MacLachlan M. (2010). Trinity Amputation and Prosthesis Experience Scale: a psychometric assessment using classical test theory and Rasch Analysis. American Journal of Physical Medicine & Rehabilitation, 89 (6): 487-496. DOI: 10.1097/PHM.0b013e3181dd8cf1
  33. Gallagher P. and MacLachlan M. (2000). Development of psychometric evaluation of Trinity Amputation and Prosthesis Experience Scales (TAPES). Rehabilitation Psychology, 45 (2): 130-154. DOI: 10.1037/0090-5550.45.2.130
  34. Graham L., Parke R.C., Paterson M.C., Stevenson M. (2006). A study of the physical rehabilitation and psychological state of patients who sustained limb loss as a result of terrorist activity in Northern Ireland 1969-2003. Disability & Rehabilitation, 28 (12): 797- 801. DOI: 10.1080/09638280500386742
  35. Hamill R., Carson S. and Dorahy M. (2010). Experiences of psychosocial adjustment within 18 months of amputation: an interpretative phenomenological analysis. Disability & Rehabilitation, 32 (9): 729-740. DOI: 10.3109/09638280903295417
  36. Hanley M.A., Jensen M.P., Ehde D.M., Hoffman A.J., Patterson D.R. and Robinson L.R. (2004). Psychosocial predictors of long-term adjustment to lower-limb amputation and phantom limb pain. Disability & Rehabilitation, 26 (14/15): 882-893. DOI: 10.1080/09638280410001708896
  37. Hawamdeh Z.M., Othman Y.S. and Ibrahim A.I. (2008). Assessment of anxiety and depression after lower limb amputation in Jordanian patients. Journal of Neuropsychiatry Disease and Treatment, 4 (3): 627-633. DOI: 10.2147/NDT.S2541
  38. Heinemann A.W., Bode R.K. and O’Reilly C. (2003). Development and measurement properties of the Orthotics and Prosthetics Users’ Survey (OPUS): a comprehensive set of clinical outcome instruments. Prosthetics & Orthotics International, 27 (3): 191-206. DOI: 10.1080/03093640308726682
  39. Herrmann C. (1997). International experiences with the Hospital Anxiety and Depression Scale – A review of validation data and clinical results. Journal of Psychosomatic Research, 42 (1): 17-41. DOI: 10.1016/S0022-3999(96)00216-4
  40. Horgan O. and MacLachlan M. (2004). Psychosocial adjustment to lower limb amputation: a review. Disability & Rehabilitation, 26 (14/15): 837-850. DOI: 10.1080/09638280410001708869
  41. Hubbard Winkler S.L. (2008). Upper limb amputation and prosthetics epidemiology, evidence, and outcomes. In: Pasquina P. and Cooper R.A., editors, Rehabilitation of Combat Casualties with Limb. Textbooks of Military Medicine, the Borden Institute. Washington DC: Borden Institute, pp. 597-605.
  42. Hudak P.L., Amadio P.C. and Bombardier C. (1996). Development of an upper extremity outcome measure: The DASH (Disabilities of the Arm, Shoulder, and Hand). The Upper Extremity Collaborative Group (UECG). American Journal of Industrial Medicine, 29 (6): 602-608. DOI: 10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L
  43. Kratz A.L., Williams R.M., Turner A.P., Raichle K.A., Smith G.D. and Ehde D. (2010). To lump or to split? Comparing individuals with traumatic and nontraumatic limb loss in the first year after amputation. Rehabilitation Psychology, 55 (2): 126-138. DOI: 10.1037/a0019492
  44. Krauseneck T., Rothenhausler H.B., Schelling G. and Kapfhammer H.P. (2005). PTSD in somatic disease. Fortschritte der Neurologie Psychiatrie, 73 (4): 206-217. DOI: 10.1055/s-2004-830108
  45. Lindner H.Y.N., Natterlund B.S. and Hermansson L.M.N. (2010). Upper limb prosthetic outcome measures: review and content comparison based on International Classification of Functioning, Disability and Health. Prosthetics and Orthotics International, 34 (2): 109-128. DOI: 10.3109/03093641003776976
  46. Livneh H., Antonak R.F. and Gerhardt J. (1999). Psychosocial adaptation to amputation: the role of socio-demographic variables, disability related factors and coping strategies. International Journal of Rehabilitation Research, 22 (1): 21-31. DOI: 10.1097/00004356-199903000-00003
  47. Melcer T., Walker G.J., Galarneau M., Belnap B. and Konoske P. (2010). Midterm health and personnel outcomes of recent combat amputees. Military Medicine, 175 (3): 147- 154.
  48. Mosaku K.S., Akinyoola A.L., Fatoye F.O. and Adegbehingbe O.O. (2009). Psychological reactions to amputation in a sample of Nigerian amputees. General Hospital Psychiatry 31 (1): 20-24. DOI: 10.1016/j.genhosppsych.2008.08.004
  49. Mhurchadha S.N., Schaffalitzky E., Gallagher P. and MacLachlan M. (2008). Psychological fit of a prosthetic arm: an illustrative case study using repertory grid analysis with a user of a high-tech upper limb prosthesis. In: Gallagher P., Desmond D. and MacLachlan M., editors, Psychoprosthetics. London: Springer, pp. 155-161.
  50. Moscato T.A. e Gazzotti V., a cura di (2004). La riabilitazione nel paziente amputato. [Amputee rehabilitation in the patient]. Budrio: Centro Protesi INAIL
  51. Murray C.D. (2005). The social role of prosthesis use. Journal of Health Psychology, 10 (3): 425-441. DOI: 10.1177/1359105305051431
  52. Murray C.D. (2009). Being like everybody else: the personal meanings of being a prosthesis user. Disability & Rehabilitation, 31 (7): 573-581. DOI: 10.1080/09638280802240290
  53. Oaksford K., Frude N. and Cuddihy R. (2005). Positive coping and stress-related psychological growth following lower limb amputation. Rehabilitation Psychology, 50 (3): 266- 277. DOI: 10.1037/0090-5550.50.3.266
  54. Østlie K., Magnus P., Skjeldal O.H., Garfelt B. and Tamps K. (2011). Mental health and satisfaction with life among upper limb amputees: a Norwegian population-based survey comparing adult acquired major upper limb amputees with a control group. Disability & Rehabilitation, 33 (17/18): 1594-1607. DOI: 10.3109/09638288.2010.540293
  55. Pajardi D. e Viano A. (2007a). Esiti delle amputazioni alla mano: evoluzione complicanze psicologiche. [Outcome of amputations in the hand: Evolution psychological complications]. In: Landi A., Catalano F. e Luchetti R., a cura di, Trattato italiano di chirurgia della mano. [Italian treatise of hand surgery]. Vol. 1. Roma: Verducci, pp. 553-557.
  56. Pajardi D. e Viano A. (2007b). Amputazione della mano: aspetti psicologici, [Amputation of the hand: the psychological aspects]. In: Landi A., Catalano F. e Luchetti R., a cura di, Trattato italiano di chirurgia della mano. [Italian treatise of hand surgery]. Vol. 1. Roma: Verducci, pp. 549-551
  57. Papassotiropoulos A. and Heun R. (1999). Screening for depression in the elderly: A study on misclassification by screening instruments and improvement of scale performance Progress in Neuro-Psychopharmacology and Biological Psychiatry, 23 (3): 431-446. DOI: 10.1016/S0278-5846(99)00007-X
  58. Parker K., Kirby R.L., Adderson J. and Thompson K. (2010). Ambulation of people with lower-limb amputations: relationship between capacity and performance measures. Archives of Physical Medicine and Rehabilitation, 9 (4): 543-549. DOI: 10.1016/j.apmr.2009.12.009
  59. Phelps L.F., Williams R.M., Raichle K.A., Turner A.P. and Ehde D.M. (2008). The importance of cognitive processing to adjustment in the 1st year following amputation. Rehabilitation psychology, 53 (1): 28-38. DOI: 10.1037/0090-5550.53.1.28
  60. Pillet J. and Didierjean-Pillet A. (2001). Aesthetic hand prosthesis: gadget or therapy? Presentation of a new classification. Journal of Hand Surgery, 26 (6): 523-528.
  61. Quale A.J. and Schanke A.K. (2010). Resilience in the face of coping with a severe physical injury: a study of trajectories of adjustment in a rehabilitation setting. Rehabilitation Psychology, 5 (1): 12-22. DOI: 10.1037/a0018415
  62. Radloff L.S. (1977). The CES-D scale: a self-report depression scale for research in general population. Applied Psychological Measurement, 1 (3): 385-401. DOI: 10.1177/014662167700100306
  63. Remes L., Isoaho R., Vahlberg T., Viitanen M., Koskenvuo M. and Rautava P. (2010). Quality of life three years after major lower extremity amputation due to peripheral arterial disease. Aging Clinical and Experimental Research, 22 (5/6): 395-405.
  64. Robert R., Lewinsohn P.M. and Seeley J.R. (1991). Screening for adolescent depression: a comparison of scales. Journal of the American Academy of Child & Adolescent, 30 (1): 58-66. DOI: 10.1097/00004583-199101000-00009
  65. Robert R., Ottaviani G., Huh W.W., Palla S. and Jaffe N. (2010). Psychosocial and functional outcomes in long-term survivors of osteosarcoma: a comparison of limb-salvage surgery amd amputation. Pediatric Blood & Cancer, 54: 990-999
  66. Rybarczyk B., Edwards R. and Behel, J. (2004). Diversity in adjustment to limb amputations: case illustrations of common themes. Disability & Rehabilitation, 26 (14/15): 944- 953. DOI: 10.1080/09638280410001708986
  67. Sanavio E. e Sica C. (1999). I test di personalità. Inventari e questionari. [The personality test. Inventories and questionnaires]. Bologna: Il Mulino
  68. Saradjian A., Thompson A.R. and Datta D. (2008). The experience of men using an upper limb prosthesis following amputation: positive coping and minimizing feeling different. Disability & Rehabilitation, 30 (11): 871-883. DOI: 10.1080/09638280701427386
  69. Schaffalitzky E., Mhurchadha S.N., Gallagher P., Hofman S., MacLachlan M. and Wegener S.T. (2009). Indentifying the values and preferences of prosthetic users: a case study series using the repertory grid technique. Prosthetics and Orthotics International, 33 (2): 157-166. DOI: 10.1080/03093640902855571
  70. Shih R.A., Schell T.L., Hambarsoomian K., Belzberg H. and Marshall G.N. (2010). Prevalence of posttraumatic stress disorder and major depression after trauma center hospitalization. Journal of Trauma-Injury Infection and Critical Care, 69, 6: 1560-1566. DOI: 10.1097/TA.0b013e3181e59c05
  71. Singh R., Hunter J. and Philip A. (2007). Rapid resolution of depression and anxiety after amputation. Clinical Rehabilitation, 21 (8): 754-759. DOI: 10.1177/0269215507077361
  72. Singh R., Ripley D., Pentland B., Todd I., Hunter J., Hutton L., and Philip A. (2009). Depression and anxiety symptoms after lower limb amputation: the rise and fall. Clinical Rehabilitation, 23 (3): 281-286. DOI: 10.1177/0269215508094710
  73. Snaith R.P. and Zigmond A. S. (1994). HADS: Hospital Anxiety and Depression Scale. Windsor: NFER Nelson
  74. Spitzer R.L., Kroenke K. and Williams J.B. W. (1999). Validation and utility of a self-report version of the PRIME-MD. Journal of the American Medical Association, 282 (18): 1737-1744. DOI: 10.1001/jama.282.18.1737
  75. Unwin J., Kacperek L. and Clarke C. (2009). A prospective study of positive adjustment to lower limb amputation. Clinical Rehabilitation, 23 (11): 1044-1050. DOI: 10.1177/0269215509339001
  76. Wald J. and Alvaro R. (2004). Psychological factors in work-related amputation: considerations for rehabilitation counselors. Journal of Rehabilitation, 70 (4): 6-15.
  77. Williams R.M., Ehde D.M., Smith D.G., Czerniecki J.M., Hoffman A.J. and Robinson L.R. (2004). A two-years longitudinal study of social support following amputation. Disability & Rehabilitation, 26 (14/15): 862-874. DOI: 10.1080/09638280410001708878
  78. Williams A.E., Newman J.T., Ozer K., Juarros A., Morgan S.J. and Smith W.R. (2009). Posttraumatic stress disorder and depression negatively impact general health status after hand injury. Journal of Hand Surgery – American Volume, 34 (3): 515-522. DOI: 10.1016/j.jhsa.2008.11.008
  79. World Health Organization (2001). International Classification of Functioning, Disability, and Health (ICF). Geneva, Switzerland: World Health Organization
  80. Zigmond A.S. and Snaith R.P. (1983). The Hospital and Anxiety Depression Scale. Acta Psychiatrica Scandinavica, 67 (6): 361-370. DOI: 10.1111/j.1600-0447.1983.tb09716.x

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Martina Luchetti, Andrea Giovanni Cutti, Ornella Montebarocci, Gennaro Verni, Nicolino Cesare Franco Rossi, Reazioni psicologiche in soggetti con amputazione di arto: una rassegna della letteratura in "PSICOLOGIA DELLA SALUTE" 1/2013, pp 49-70, DOI: 10.3280/PDS2013-001003