PSYCHIATRIC DISTURBANCES FOLLOWING AMPUTATION
DOUGLAS NOBLE M. D.1,
DOUGLAS B. PRICE M. C., U.S.A.2, , and
RODMAN GILDER JR. M. C.,U.S.N.R.3
1 Consultant in psychiatry, U. S. Naval Hosp., Bethesda, Md.
2 Walter Reed Army Hosp., Washington, D. C.
3 Naval Medical Research Institute, Bethesda, Md.
Little reference has been made in this report to psychiatric treatment. It is believed that the function of the psychiatrist lies chiefly in his availability for consultation and collaboration with surgical and nursing personnel; rarely is direct psychiatric therapy necessary. The major purpose of our study has been to indicate how the loss of an extremity or the loss of its function involves emotional problems beyond the loss itself. As a result increased disability both in amputation and in organic neurological disease may occur. Characteristically, the anxieties are concerned with separation, castration, and with aggressive impulses.
In the presence of a threat to bodily integrity pre-existing modes of dealing with anxiety are organized. And to the degree to which this process is tied to reality, adjustment or maladjustment to the loss occurs. Evidences of prolonged maladjustment have been observed when the defence or projection has been heavily invoked. In the study of defence mechanisms the correlation of perceptual tests with clinical data has proven valuable.
