Low depressive symptoms in acute spinal cord injury compared to other neurological disorders

Abstract

The aim of the study was to reveal the incidence and time course of depressive symptoms following acute spinal cord injury (SCI) in relation to clinical outcomes for comparison to other neurological disorders with severe impairment. In patients with acute traumatic SCI (n = 130), combined follow up assessments of neurological and functional outcomes, pain and patient-rated affective factors (e.g. mood, anxiety) were prospectively (1, 3, 6, 12 months after injury) collected during rehabilitation and follow up in out-patient clinics. We related these to the severity of depressive symptoms (no, mild, moderate and severe) based on the Beck Depression Inventory (BDI) scores. The mean 65% of patients showed no depressive symptoms and 30% mild depressive symptoms, while less than 5% presented moderate to severe depressive symptoms. The group findings and symptoms in individual patients remained stable over 1 year though patients revealed significant clinical recovery. Although two-thirds of the patients experienced pain, BDI scores were not related to pain intensity. BDI mean scores were only slightly higher than in control populations, but rather low compared to patients with other neurological disorders (e.g. stroke and multiple sclerosis) that are also associated with severe functional impairment. The prevalence of depressive symptoms following acute SCI is rather low and remains stable within the first year after injury despite the severe neurological impairment and loss of independency. In comparison to other neurological disorders that also involve brain function SCI patients seem to be less challenged by depressive symptoms that constitute additional burdens to respond to the severe functional impairments.

Depression Following Spinal Cord Injury: Its Relationship to Demographic and Socioeconomic Indicators

“…The overall prevalence of depression in various SCI studies ranges from 11% to78%. 2,4,7,8,12,13,[23][24][25] Contrary to results of other studies, 9,26 our findings show that although the prevalence of depression was lower for longer durations of SCI, there was no significant correlation between the duration of SCI and BDI score. Unfortunately, in individuals more than 1 year after SCI, the prevalence of depression noted in our study was still high.…”

“…This was in contrast to the results of studies by Anderson et al 2 and Shin et al, 5 which showed no significant difference in depression between individuals with tetraplegia and those depression was lower than that reported by Shin et al 5 (63.9% within the first 6 months after SCI) and Wang et al 23 (62.5% at week 6), similar to that reported by Krause, Kemp, and Coker 8 (48%), and higher than that reported in multiple other studies. 2,4,7,12,13,19,24 The vast differences in the frequency of depression reported in various studies may be due to differences in survey questionnaires or length of time post SCI. For example, in the study by Wang et al, 23 the prevalence of depression was 78% at week 1 post SCI (mean BDI score, 18.33 ± 10.48), which significantly decreased to 62.5% at week 6 (mean BDI score, 14.36 ± 9.94).…”

“…5 The prevalence of probable depression after SCI ranges from 9.8% to 63.9% among inpatients and people living in the community. 2,[5][6][7][8][9][10][11][12][13] Depression symptoms are associated with many problems among individuals with SCI including lower functional independence, 14 more secondary complications, 15 less community and social integration, 11,16 and a lower mean American…”

The Use of Short Form 36 and Beck Depression Inventory in Acute Cervical Spinal Cord Injury Patients

“…Our results were consistent with other studies that showed depressive symptoms and BDI scores were not associated with pain severity [32][33][34]. Tate et al reported that age was related to pain, with younger subjects reporting higher levels [33].…”

Grieving my broken body: an autoethnographic account of spinal cord injury as an experience of grief

“…So, for example, Fann et al [14] conclude that depression amongst persons with an SCI is three times greater than that of the general population, with 23% of the SCI population having moderate to high depression scores. On the other hand, Hassenpour et al [15] observe that the frequency of depressive symptoms among people with SCI are low; ''65% of patients showed no depressive symptoms and 30% mild depressive symptoms, while less than 5% presented moderate to severe depressive symptoms''. Yet, irrespective of the methodological differences between these studies, what is clear is that most people with SCI are not subject to debilitative depression following their injury.…”