Psychological morbidity and spinal cord injury: a systematic review

Abstract

Study Design: A systematic review of the literature concerning the nature of the psychological morbidity in people with spinal cord injury (SCI). Objectives: SCI is believed to place the individual at a high risk of psychological morbidity. The objective of this paper was to examine systematically the prevalence of negative psychological states in people with SCI, as well as to explore mediating and contextual factors. Methods: Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as SCI, depression, anxiety and so on. Only studies that fulfilled certain criteria such as the use of valid measures in assessing psychological morbidity were used in the review process. Results: The systematic review revealed that clarification is still needed concerning the psychological consequences of people with SCI. However, findings suggest that approximately 30% of people with SCI are at risk of having a depressive disorder although in rehabilitation, and approximately 27% are at risk of having raised depressive symptoms when living in the community. The review also established that people with SCI have higher comparative risks of anxiety disorder, elevated levels of anxiety, feelings of helplessness and poor quality of life (QOL). Conclusion: People with SCI have an increased risk of suffering debilitating levels of psychological morbidity. Future research needs to clarify the extent and nature of psychological morbidity following SCI by conducting prospective and comprehensive research in large heterogeneous samples of people with SCI during the rehabilitation phase and following reintegration into the community.

Psychological intervention during spinal rehabilitation: a preliminary study

“…The finding that distress levels of treatment participants were severe at the commencement of rehabilitation reinforces the need for psychological intervention in the acute stages of SCI management. 1 With self-reported distress levels increasing post-discharge, the continued mental health needs of this patient group are also evident. 1,19 These results need to be interpreted in light of the methodological difficulties.…”

“…1 With self-reported distress levels increasing post-discharge, the continued mental health needs of this patient group are also evident. 1,19 These results need to be interpreted in light of the methodological difficulties. Power analyses (Table 3) indicate that the study was underpowered.…”

“…The psychological impact of spinal cord injury (SCI) is significant, with 30% of patients showing clinical levels of anxiety and/or depression during rehabilitation 1 and after returning to community living. 2 Research suggests that specialist psychological interventions have a role in managing these emotional outcomes.…”

Anxiety prevalence following spinal cord injury: a meta-analysis

“…2 Heightened distress may be triggered by the traumatic nature of some SCIs, 3,4 the ongoing fear of secondary life-threatening consequences (for example, autonomic dysreflexia 5 ), or pre-injury psychological morbidity. 2,6 Notably, the SCI and anxiety research is characterised by wide ranging prevalence estimates, thereby limiting the interpretation of these data.…”

Positive and negative affect in individuals with spinal cord injuries

“…1 However, a burgeoning literature has recently identified a number of emotional dysfunctions in these patients and has focused attention on the urgent need to address these issues during both acute and outpatient treatment. 2 The majority of the existing studies of emotional impairments in individuals with SCIs have focused on depression, as it is the most common psychopathology following SCI. 1 Indeed, the incidence rate in individuals with SCIs is much higher than that of healthy individuals 3 with estimates ranging from 10-30% of this patient group.…”