@article{ref1,
title="Association between traumatic spinal cord injury and affective and other psychiatric disorders-a nationwide cohort study and effects of rehabilitation therapies",
journal="Journal of affective disorders",
year="2020",
author="Wan, Fang-Jung and Chien, Wu-Chien and Chung, Chi-Hsiang and Yang, Yun-Ju and Tzeng, Nian-Sheng",
volume="265",
number="",
pages="381-388",
abstract="BACKGROUND: This study aimed to investigate the association between traumatic spinal cord injury (TSCI) and the risk of affective and other psychiatric disorders, and the role of the rehabilitation therapies. <br><br>METHODS: In this population-based, retrospective cohort study, we used Taiwan's National Health Insurance Research Database to analyze the patients who were newly diagnosed with TSCI between 2000 and 2015 were included, with a 1:3 ratio by age, sex, and index year matched in the non-TSCI comparison group, for the risk of affective and other psychiatric disorders. <br><br>RESULTS: In total, 5375 out of 16,151 patients with TSCI developed psychiatric disorders, and 1467 out of 48,543 patients in the non-TSCI group developed psychiatric disorders (2930.88 vs 2823.29 per 100,000 persons/year). The Kaplan-Meier analysis showed that the TSCI cohort had a significantly higher risk of psychiatric disorders (log-rank, p < 0.001). Fine and Gray's survival analysis revealed that the adjusted hazard ratio was 1.977 (95% CI: 1.914-2.042, p < 0.001). Rehabilitation therapies, including physical and occupational therapies, within 90 days after the injury, was associated with a lowered risk of psychiatric disorders, including anxiety, depression, and bipolar disorder, in the TSCI cohort (adjusted HR = 0.702 [95% CI: 0.661-0.746, p < 0.001]). In the subgroups with low, medium, and high intensity, rehabilitation therapies were associated with a lowered risk of psychiatric disorders. <br><br>CONCLUSIONS: TSCI was associated with the risk of affective and other psychiatric disorders, and rehabilitation therapies were associated with a lowered risk of these in the TSCI cohort.<br><br>Copyright © 2020. Published by Elsevier B.V.<p /> <p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2020.01.063",
url="http://dx.doi.org/10.1016/j.jad.2020.01.063"
}