Evidence map›Paper›PMID 42232879›Full record

ArticleEClinicalMedicine2026

The association between quality of life, anxiety and depression, and residual limb and phantom limb pain in war-related amputees: a year-long observational study.

Roman Smolynets, Joana Barroso, Paul F Pasquina, Steven P Cohen

Erratum issuedAbstract read
In one paragraph

Article in EClinicalMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Roman SmolynetsDepartment of Anesthesiology, Lviv Territorial Medical Union, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
Joana BarrosoDepartments of Anesthesiology, Physical Medicine and Rehabilitation and Neuroscience, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Paul F PasquinaDepartment of Physical Medical & Rehabilitation, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Steven P CohenDepartments of Anesthesiology, Neurology, Physical Medicine & Rehabilitation, Psychiatry and Neurological Surgery, Northwestern University Feinberg School of Medicine, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Postamputation pain (PAP) is associated with significant reductions in quality of life and psychiatric co-morbidities, with the relationship being bidirectional. In military service members, amputation and its sequelae are associated with these decrements, though the relationship between PAP, psychiatric symptoms and quality of life (QoL) has not been explored. Methods: In a prospective cohort of 156 Ukrainian war-related amputees treated between June 2023 and September 2024, phantom limb pain (PLP), residual limb pain (RLP) (0-10 NRS), anxiety, depression (HADS-A/HADS-D), and QoL (0-100 VAS) were assessed longitudinally (baseline, 3, 6, 12 months). Mixed-effects repeated-measures models tested time effects and time-varying associations of anxiety, depression, and QoL with PLP and RLP. Cross-lagged panel models tested prospective, directional associations between psychological factors and subsequent PLP/RLP across follow-up while accounting for pain stability and within-wave correlations. Findings: Outcomes improved over time, with mixed-effects models showing a strong time effect for both PLP (P < 0.001) and RLP (P < 0.001). Higher QoL was associated with lower PLP and RLP (both P < 0.001), while higher anxiety and depression were associated with greater RLP (both P ≤ 0.005). In cross-lagged models, depressive symptoms and anxiety were associated with higher subsequent PLP, whereas QoL was associated with lower subsequent PLP; PLP showed no lagged associations with later depression, anxiety, or QoL. For RLP, the only directional lagged association was with later depressive symptoms. Interpretation: In war-related amputees, PLP and RLP improve substantially over 12 months alongside reduced psychological distress and improved QoL. QoL is robustly linked to both pain outcomes across recovery, while anxiety and depression show stronger (and time-varying) relationships with RLP than PLP. Cross-lagged models indicated that affective/QoL measures were linked to later PLP, while RLP was linked to later depressive symptoms, supporting distinct coupling mechanisms. Funding: The U.S. Department of Defense funded this study (personnel costs).

Indexed as

AmputationPhantom limbPredictorPsychologicalQuality of lifeResidual limbWar

Identifiers

PMID42232879
PMCPMC13223364

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.