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Journal Article

Citation

McCullumsmith CB, Kalpazian C, Richards JS, Forchheimer M, Heinemann AW, Richardson E, Wilson C, Barber J, Temkin N, Fann JR, Bombardier CH. Arch. Phys. Med. Rehabil. 2015; 96(5): 799-808.

Affiliation

University of Washington, Seattle, WA.

Copyright

(Copyright © 2015, Elsevier Publishing)

DOI

10.1016/j.apmr.2014.12.017

PMID

25613597

Abstract

OBJECTIVE: To determine unique associations for suicidal ideation and historical suicide attempts among individuals with spinal cord injury (SCI).

DESIGN: Cross-sectional analysis SETTING: Outpatient PARTICIPANTS: 2,533 individuals with SCI 18 years or older with a history of traumatic SCI. INTERVENTIONS: None MAIN OUTCOME MEASURES: Any suicidal ideation in the prior 2 weeks (PHQ-9 item; SI) and any historical suicide attempt (SA).

RESULTS: 323 (13.3%) reported SI in the prior 2 weeks and 179 (7.4%) reported historical SA. After controlling for other factors, both historical SA and current SI were associated with study site and current level of depression. Additionally, SA was associated with less education, younger age at injury, having current or prior treatment for depression, and having bipolar disorder or schizophrenia. SI was associated with more years since injury and previous SA. Several psychological factors were associated with current SI and historical SAs, including lower environmental reward and less positive affect. Additionally, control of one's community activities and spiritual well-being were associated with current SI. Severity of SCI also was associated in bivariate comparisons with the 47% of the SAs which occurred after injury.

CONCLUSION: Several unique associations for SI and historical SA in individuals with SCI were identified, including level of environmental reward and control, spiritual well-being and severity of SCI. These factors bear further investigation as prospective risk factors for suicidal behavior after SCI.


Language: en

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