The influence of depression on physical complications in spinal cord injury: behavioral mechanisms and health-care implications

Abstract

Study Design: This study is a literature review and a proposed conceptual model. Objectives: The objective of this study is to develop a conceptual model to explore the relationship between the presence of depressive symptoms and secondary physical complications such as pressure ulcers, urinary tract infections and autonomic dysreflexia in spinal cord injury (SCI). Setting: Community setting for individuals with SCI. Methods: A conceptual model explaining the mechanism underlying the relationship between depression and secondary physical SCI complications was developed based on the International Classification of Functioning, Disability and Health (ICF). A literature review was conducted to develop the model and to identify potential mechanisms responsible for the association.Results: A conceptual model based on ICF was created, informed by the literature discussing the link between depression and secondary physical SCI complications. Evidence in the literature was located that supports both a causal connection between depression and increased physical complications and/or the potential mechanisms mediating that connection. Conclusion: The proposed model can be utilized to encourage further research on the influence of depression on SCI outcomes and the importance of prompt and effective identification and treatment of depressive symptoms. Additional research is needed to assess the relationship between depression and secondary physical SCI complications, and to test the validity of the model.

Perceived facilitators and barriers to self-management in individuals with traumatic spinal cord injury: a qualitative descriptive study

“…It has been previously concluded that depression can “lead to apathy in terms of self-care” [56]. However, studies also support the idea of “feedback loops” where certain patient factors and increased complications following depression may in turn accentuate the initial depression [57]. Indeed, secondary complications were identified as a barrier to self-management in the current study and thus may be acting as barriers in and of themselves (i.e., decreases in functional capacity) or may be contributing to this described feedback loop.…”

Endoplasmic Reticulum Stress and Disrupted Neurogenesis in the Brain Are Associated with Cognitive Impairment and Depressive-Like Behavior after Spinal Cord Injury

“…8,[10][11][12][13][14] Cognitive/emotional impairments may be detrimental to SCI patients not only in their own right, but because they can compromise rehabilitation and impair recovery. 15,16 Recent experimental studies have reported that SCI in rodent models causes impairment of spatial and retention memory and depressive-like behavior.…”

Associação entre sintomas depressivos e disfunção sexual em homens com lesão medular traumática

“…recuperação da função sexual através da readaptação à nova condição, bem como a plasticidade das vias nervosas responsáveis pelos comandos autonômicos e função sexual. Além disso, ocorre melhora nos níveis de testosterona e descoberta de outras zonas erógenas que compensam a ausência de sensação genital 23 .…”