Citation

Hartoonian N, Hoffman JM, Kalpakjian CZ, Taylor HB, Krause JK, Bombardier CH. Arch. Phys. Med. Rehabil. 2014; 95(3): 455-465.

Affiliation

Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: narhart@uw.edu.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.apmr.2013.10.029

PMID

24269994

Abstract

OBJECTIVE: To determine whether demographic, injury, health, and functional factors similarly have the same predictive relationship with both somatic and non-somatic symptoms of depression, as well as whether somatic and non-somatic symptoms of depression have the same association with quality of life (QOL). DESIGN: Secondary analysis of cross-sectional survey data. SETTING: SCI Model Systems National Database. PARTICIPANTS: 4976 participants with traumatic SCI who completed an interview at 1-year post injury between 2006 and 2011. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Somatic and non-somatic symptoms of depression from the Patient Health Questionnaire-9 and quality of life measured by the Satisfaction With Life Scale (SWLS). RESULTS: Structural equation modeling (SEM) showed that the hypothesized model provided a good fit to the data, but modification of the model lead to a significant improvement in model fit, Δχ(2)(1) = 226.21, p < .001; CFI = .976; χ(2)(199) = 585.39, p < .001; RMSEA = .027 (90% C.I.: .025 - .030). The health-related factors including pain severity, pain interference, and health status were similarly associated with both somatic and non-somatic symptoms of depression. Quality of life was negatively associated with non-somatic symptoms of depression, but was unrelated to somatic symptoms of depression. CONCLUSIONS: Assessment of depression after SCI should include a careful assessment of health concerns given the relationship between health-related factors and both somatic and non-somatic symptoms of depression. Treatments for depressive symptoms may be improved by targeting health concerns, such as pain, along with a specific focus on non-somatic symptoms in order to improve QOL.

Language: en