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Citation
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Craig A, Perry KN, Guest R, Tran Y, Dezarnaulds A, Hales A, Ephraums C, Middleton J. Arch. Phys. Med. Rehabil. 2015; 96(8): 1426-1434. |
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Affiliation
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John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney, NSW, Australia. |
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Abstract
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OBJECTIVE: To conduct a prospective study of the occurrence of psychological disorders and co-morbidities following spinal cord injury (SCI), determine psychotropic medication usage, and establish predictors of psychological disorders after transition to the community.
DESIGN: Longitudinal design with multiple measures SETTING: Assessment occurred in SCI Units and the community. PARTICIPANTS: Participants included 88 adults with SCI, admitted over a period of 32 months into three SCI Units in Sydney, Australia. INTERVENTIONS: Participants completed inpatient rehabilitation for an acute SCI. Longitudinal assessment occurred up to six-months post-discharge. MAIN OUTCOME MEASURES: Measures were chosen that had a theoretical and clinical foundation for contributing to recovery following SCI. The Mini International Neuropsychiatric Interview, a structured diagnostic psychiatric interview, was conducted to determine presence of psychological disorders. Medical measures included severity of secondary conditions or complications. Psychological measures included measures of anxiety and depressive mood, resilience, pain catastrophization, self-efficacy and cognitive capacity.
RESULTS: Rates of psychological disorder of 17 to 25% were substantially higher than rates found in the Australian community. The occurrence of psychological disorder co-morbidities was also very high. Anxiety was significantly elevated in those with a psychological disorder. Psychotropic medications were prescribed to over 36% of the sample, with the majority being anti-depressants. Factors predictive of psychological disorders included years of education, pre-morbid psychiatric/ psychological treatment, cognitive impairment, secondary complications, resilience and anxiety.
CONCLUSIONS: SCI can have a substantial negative impact on mental health that does not change up to six months post-discharge.
FINDINGS suggest a substantial minority experience increased psychosocial distress after the injury and after transitioning into the community. Additional resources should be invested into improving the mental health of adults with SCI.
Language: en |