Comparison of depression, anxiety and stress in persons with traumatic and non-traumatic post-acute spinal cord injury

Migliorini, Christine; New, Peter W; Tonge, Bruce John

doi:10.1038/sc.2009.43

Cited by 58 publications

(53 citation statements)

References 18 publications

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“…53 Co-occurring symptoms and psychiatric conditions should also be considered in future research. Migliorini et al [30][31][32][33] did provide these data and found that 29% of their sample reported clinical symptoms of anxiety, along with depression and general distress. Similarly, Craig et al [23] identified GAD comorbidities (e.g.…”

Section: Discussionmentioning

confidence: 93%

“…As data used for a meta-analysis should be sourced from independent samples, the studies were also checked so that there was no overlap in the samples utilised. 42 Six studies 25,[30][31][32][33][34] were subsequently pooled into two studies. Specifically, only the study providing the largest sample size was included.…”

Section: Eligibility Criteriamentioning

confidence: 99%

“…The full-texts of these studies were subsequently examined by both authors. 1,8,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] The reference lists of these studies and published SCI review papers 2,10,11,41 were additionally examined. Although this process did not lead to the discovery of any new studies, it helped ensure that all relevant papers were identified.…”

Section: Eligibility Criteriamentioning

confidence: 99%

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Anxiety prevalence following spinal cord injury: a meta-analysis

Dorstyn

2016

Spinal Cord

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Study design: Meta-analysis. Objectives: Prevalence estimates indicate that anxiety following spinal cord injury (SCI) is a common problem. However, methodological differences between studies may impact the clinical interpretation of these data. Methods: Data from 18 independent studies (N participants = 3158), which reported the prevalence of an anxiety disorder or associated symptoms, were identified from the Embase, PubMed and PsycInfo databases. Proportions were the primary effect size estimate. Confidence intervals, fail-safe Ns and the I 2 statistic were additionally calculated to identify the extent to which findings were robust and consistent across studies. Results: Five per cent of participants met the criteria for either GAD or panic disorder, with Agoraphobia identified in 2.5%. These diagnostic data were, however, limited to two studies. Higher rates were noted for self-reported 'caseness' of anxiety, with 27% reporting clinically significant symptoms. Anxiety prevalence estimates varied across the individual self-report measures (range: 15-32%). Method of administration (range: 26-32%) did not impact significantly on these estimates nor did recruitment source, with similarly high anxiety levels reported by hospital (27%) and community (29%) samples. Conclusions: Early identification and treatment of anxiety are important in SCI rehabilitation, with a subgroup of individuals experiencing chronic symptoms. Further research is needed to establish guidelines for the interpretation of self-report data, including the use of clinical cutoffs.

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Section: Discussionmentioning

confidence: 93%

Section: Eligibility Criteriamentioning

confidence: 99%

Section: Eligibility Criteriamentioning

confidence: 99%

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Anxiety prevalence following spinal cord injury: a meta-analysis

Dorstyn

2016

Spinal Cord

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“…Overall, research has found the aetiology of SCI to have little or no effect on individuals' psychological well-being, in relation to anxiety, depression, stress and quality of life, 16,17 and researchers have even suggested no apparent differences in post-traumatic stress disorder. 18 These results, therefore, suggest that a similar approach to aiding patients' psychological wellbeing in rehabilitation settings would be effective in both individuals with traumatic and non-traumatic injuries.…”

Section: Introductionmentioning

confidence: 99%

Traumatic versus non-traumatic spinal cord injuries: are there differential rehabilitation outcomes?

Kennedy

Chessell

2013

Spinal Cord

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Study design: Retrospective case review. Objectives: To compare the rehabilitation outcomes between patients with traumatic spinal cord injuries and patients with nontraumatic spinal cord injuries, using The Needs Assessment Checklist (NAC), to observe if both the groups benefit from the same rehabilitation programme. Setting: Tertiary care, spinal cord injury rehabilitation unit (National Spinal Injuries Centre), Stoke Mandeville Hospital, UK. Methods: Information obtained with the NAC at two time points during patients' rehabilitation was examined. Statistical analysis investigated the rehabilitation outcomes both between and within groups. Results: Initial differences were observed on admission between patients with traumatic and non-traumatic spinal cord injuries in five of the ten rehabilitation domains measured, with patients with non-traumatic injuries presenting with better outcomes. At a later stage in patients' rehabilitation, however, differences between the groups had lessened. Furthermore, the results demonstrated that the whole cohort made significant improvements in all the ten rehabilitation domains, with the same finding evident for both patients with traumatic and patients with non-traumatic spinal cord injuries. Conclusion: Patients with traumatic spinal cord injuries and patients with non-traumatic spinal cord injuries benefitted from the same rehabilitation programme in a spinal injury centre, making significant improvements in all ten rehabilitation domains measured, suggesting that it is effective to admit and rehabilitate patients with injuries resulting from both traumatic and non-traumatic aetiologies in the same specialised setting.

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“…Depression and anxiety in the spinal cord injury population have prevalence rates of 21-37% and 19-29%, respectively, and these conditions have been positively associated with SHCs, health care utilization and more frequent use of prescription medications. [20][21][22][23] The prevalence of major depressive disorder in the pediatric-onset SCI population has been reported to be significantly lower compared with that of the adult-onset SCI, as well as the general population; 24,25 however, given the fact that antidepressants were the fifth most common routine medication, close follow-up of mental health is warranted over time, especially in relation to development of SHCs. 24,25 The increased risk of peptic ulcers and gastroesophageal reflux disease is well documented in SCI and has been attributed to unopposed vagal stimulation, decreased mucosal perfusion and persistent supine position.…”

Section: Discussionmentioning

confidence: 99%

Medication profile and polypharmacy in adults with pediatric-onset spinal cord injury

2015

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Study design: Cross-sectional survey. Objectives: To describe the medications taken by individuals who had sustained a spinal cord injury (SCI) in childhood or adolescence (age o19 years) and to report the prevalence of polypharmacy and its association with demographic, injury-related and psychosocial factors. Setting: Community. Methods: Structured interviews of adults with pediatric-onset SCI. Routine medications and secondary health conditions (SHCs) experienced were recorded. Polypharmacy was defined as the concomitant use of five or more different types of medications. Bivariate analyses and multiple regression models were conducted to determine associations between polypharmacy and demographic factors, injury-related factors, number of SHCs and psychosocial outcomes (FIM, SF-12v2 Health Survey, CHART, PHQ-9). Results: A total of 159 participants (male, 63%; tetraplegia, 59%) with mean age 35.0 ± 6.2 years (range, 26.7-50.9 years) were included. Most common routine medications were muscle relaxants (50.3%), bladder medications (48.5%), bowel agents (41.5%), analgesics (26.4%) and antidepressants (16.9%). Polypharmacy was present in 30.8% (n, 49) and was more prevalent in those with tetraplegia (40.2% vs 17.9%; P = 0.003). Participants with polypharmacy were older, had lower FIM, CHART and SF-12v2 scores, and higher PHQ-9 scores. Regression models indicate the total number of SHCs, time since injury and tetraplegia to be significant positive predictors of polypharmacy. Conclusion: Duration of SCI and SHCs are risk factors for polypharmacy in this population of adults with SCI. Measures should be taken to prevent the occurrence of SHCs throughout adulthood so as to prevent the potentially adverse physiological effects and psychosocial outcomes associated with polypharmacy.

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Comparison of depression, anxiety and stress in persons with traumatic and non-traumatic post-acute spinal cord injury

Cited by 58 publications

References 18 publications

Anxiety prevalence following spinal cord injury: a meta-analysis

Anxiety prevalence following spinal cord injury: a meta-analysis

Traumatic versus non-traumatic spinal cord injuries: are there differential rehabilitation outcomes?

Medication profile and polypharmacy in adults with pediatric-onset spinal cord injury

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