Citation

Williams R, Murray A. Arch. Phys. Med. Rehabil. 2014; 96(1): 133-140.

Affiliation

Counseling, Educational Psychology, and Research, College of Education, Health and Human Sciences, University of Memphis, 100 Ball Hall, Memphis, TN 38152. Electronic address: anmurray@memphis.edu.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.apmr.2014.08.016

PMID

25220943

Abstract

OBJECTIVES: This study uses meta-analysis to synthesize point prevalence estimates of depressive disorder diagnoses for persons who have sustained a spinal cord injury (SCI). DATA SOURCES: We searched PsycINFO, PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Dissertation Abstracts International (DAI) for studies examining depression following SCI, through 2013. We also conducted a manual search of the reference sections of included studies. STUDY SELECTION: Included studies contained persons with SCI; used a diagnostic measure of depression (i.e. an unstructured, semi-structured, or structured clinical interview, and or a clinician diagnosis); provided a diagnosis of major or minor depressive episodes for the subjects in the study; and diagnostic criteria was based on the DSM-IV or DSM-III (including Research Diagnostic Criteria, RDC) criteria. DATA EXTRACTION: The two authors of this study screened the titles and abstracts of 1,053 unique studies for inclusion in this meta-analysis. Nineteen studies, containing 35,676 subjects and 21 effect size estimates were included. DATA SYNTHESIS: The mean prevalence estimate of depression diagnosis following SCI was 22.2%, with a lower-bound estimate of 18.7% and an upper bound estimate of 26.3%. Random-effects and mixed-effects models were used in this work. A small number of study moderators were explored, including: sample gender composition, Diagnostic and Statistical Manual of Mental Disorders (DSM) version used, data collection method (primary vs. secondary), sample traumatic etiology composition, and sample injury level and completeness composition, and sample diagnostic composition. Data collection method, and DSM version, and diagnostic composition both significantly predicted variation in observed effect size estimates, with primary data collection studies having lower estimates compared to secondary data analysis studies, and with studies using DSM-IV diagnostic criteria having higher estimates compared to studies using DSM-III criteria, and with samples comprised of individuals diagnosed only with major depression having lower prevalence estimates.

CONCLUSIONS: The existing data on depression following SCI indicates that the prevalence of depression following SCI is substantially greater than the prevalence of depression in the general medical population. These results underscore the importance of continued research on measuring depression in persons with SCI and on treatments for depression following SCI.

Language: en