Psychological Adaptation to Amputation: An Overview

There are approximately 400,000 am­ putees in the United States. It has been estimated that approximately 50,000 new amputations are performed each year . 1 3 , 1 5 Most amputees are males in their early six­ ties, approximately 90 percent of the am­ putations involve the lower limb, and approximately two-thirds of lower limb amputations are necessitated by diabe­ tes mellitus and/or peripheral vascular disease. Although there are circumstances when the amputation of a chronically painful and/or infected limb may be a wel­ come therapeutic alternative to a patient, the resulting disability is never welcome. In addition, although amputation of a limb is sometimes a lifesaving measure, it exacts a physical and psychological price from the patient. Since an increasing number of amputations are performed each year due to the expanding geriatric population, 1 3 , 1 5 the process of psychological adaptation of patients to amputation seems to be a sub­ ject worthy of further investigation. Our paper will review and synthesize the literature devoted to the psychological and emotional reaction of patients to am­ putation and integrate this information with our own experience in 248 patients with 368 amputations over the last five years. This report is primarily directed to­ wards non-psychiatric allied health profes­ sionals, who, we feel, have the most impact in preventing disability and in reducing the need for professional psychiatric inter­ vention.