Psychological distress in amputees with phantom limb pain

Research suggesting that psychological factors play a role in phantom limb pain abounds in the literature. Despite recent research suggesting that the se factors exacerbate rather than cause phantom limb pain, clinicians still frequently use personality as a rationale to explain amputees' phantom lim b pain. The present study aimed to examine psychological distress in a work ing-age population of amputees not specifically seeking help for their pain . The study was conducted in two phases. Phase I included 315 amputees who completed the General Health Questionnaire (GHQ). Phase 2 included a subset of the original sample who completed the Bed? Depression Inventory (BDI). In Phase 1, although over 50% of the sample reported GHQ scores over the th reshold used to detect 'caseness, 'this was not related to phantom limb pai n. In Phase 2 of the study, only 15% of the sample reported moderate to sev ere symptoms of depression. Only 4% of the variance in phantom limb pain wa s accounted for using the overall BDI score. When BDI items were examined i ndividually within regression models, a number significantly predicted phan tom limb pain. However the items most related to phantom limb pain were tho se involved in 'performance difficulties' rather than 'negative affect.' Th e present study suggests that negative affect in amputees may be related to disability rather than pain. J Pain Symptom Manage 2001;22:938-946 (C) U.S . Cancer Pain Relief Committee, 2001.