Citation

van Leeuwen CM, Hoekstra T, van Koppenhagen CF, de Groot S, Post MW. Arch. Phys. Med. Rehabil. 2012; 93(12): 2170-2176.

Affiliation

Swiss Paraplegic Research, Nottwil, Switzerland; Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.apmr.2012.07.006

PMID

22835856

Abstract

OBJECTIVE: To study the course and predictors of mental health in the period between the start of active spinal cord injury (SCI) rehabilitation and 5 years after discharge. The hypothesis was that different mental health trajectories can be identified. DESIGN: Multi-centre prospective cohort study with measurements at the start of active rehabilitation, after 3 months, at discharge, 1, 2, and 5 years after discharge. SETTING: Eight Dutch rehabilitation centres with specialised SCI units. PARTICIPANTS: Persons (n=206) with recently acquired SCI and age between 18 and 65 years. INTERVENTIONS: Not applicable MAIN OUTCOME: The five-item Mental Health Index (MHI-5) with a total score between 0 (lowest mental health) and 100 (highest mental health). RESULTS: Levels of mental health increased between the start of active rehabilitation and three months later, remained stable thereafter, and increased again between 2 and 5 years after discharge. Latent Class Growth Mixture Modelling revealed 5 trajectories: (a) high scores (above 80) at all time-points (52%), (b) low scores (60 or below) at all time-points (4%), (c) early recovery from 40 to scores above 70 (13%), (d) intermediate scores from 60 to scores above 70 (29%), and (e) severe deterioration of scores above 70 to scores below 30 (2%). Pain, sex, and educational level were predictors to distinguish between the five trajectories. CONCLUSIONS: Five different mental health trajectories were identified between the start of active rehabilitation and 5 years after discharge. About a third of the persons with SCI still perceived moderate to severe mental health problems 5 years after discharge. Pain, sex, and educational level only predicted a small part of the variance in mental health trajectories.

Language: en