Citation

Matsuda Y, Kubo T, Fujino Y, Matsuda S, Wada F, Sugita A. J. Epidemiol. 2015; 26(1): 30-35.

Affiliation

Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health.

Copyright

(Copyright © 2015, Japan Epidemiological Association)

DOI

10.2188/jea.JE20140233

PMID

26567604

Abstract

BACKGROUND: Few studies have assessed whether treatment of acute cervical spinal cord injury (SCI) patients contributes to depression.

METHODS: Using an administrative database, we assessed patients for whom the diagnosis was unspecified injuries of cervical spinal cord (International Classification of Diseases and Injuries-10th (ICD-10) code; S14.1). We categorized patients with codes for depressive episode (ICD-10 code; F32) or recurrent depressive disorder (F33), or those prescribed antidepressants (tricyclic, tetracyclic, Selective Serotonin Reuptake Inhibitors, Serotonin Noradrenaline Reuptake Inhibitors, Trazodone, Sulpiride, or Mirtazapine) as having a depressive state. We compared the rate of each acute treatment between the depressive state group and the non-depressive state group using chi-square tests, and a multiple logistic regression model was used to identify the association between the acute treatment and depressive state.

RESULTS: There were 151 patients who were judged to be in a depressive state, and the other 2115 patients were categorized into the non-depressive state group. Intervention of intravenous anesthesia, tracheostomy, artificial respiration, and gastrostomy had a significant positive correlation with depressive state. Multiple logistic regression analysis showed that tracheostomy (odds ratio [OR] 2.18; 95% confidence interval [CI], 1.09-4.38) and artificial respiration (OR 2.28; 95% CI, 1.32-3.93) were significantly associated with depressive state, and men had a 36% reduction in the risk of depressive state compared with women (OR 0.64; 95% CI, 0.44-0.94), whereas age, wound-treatment, all of the orthopedic procedures, intravenous anesthesia, and gastrostomy were not associated with depressive state.

CONCLUSIONS: These findings suggest that tracheostomy, artificial respiration and female gender in the acute phase after cervical SCI might be associated with the development of depression.

Language: en