Saurí J, Chamarro A, Gilabert A, Gifre M, Rodriguez N, López-Blazquez R, Curcoll L, Benito-Penalva J, Soler D. Arch. Phys. Med. Rehabil. 2016; 98(6): 1165-1173.
Affiliation
Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autònoma de Barcelona, Badalona (Barcelona), Spain; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain; Faculty of Psychology, Department of Basic Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain; Serra Hunter Programme. Generalitat de Catalunya.
OBJECTIVE: To assess depression in a sample of individuals with spinal cord injury (SCI) living in the community, and to determine the prevalence of probable major depression disorder (PMDD) amongst those for whom the injury is traumatic (T-SCI) and those for whom it is not (NT-SCI).
DESIGN: Cross sectional. SETTING: Data were collected on individuals with SCI now living in the community, who completed a comprehensive follow-up assessment at the Guttmann Institute in Barcelona, Spain. PARTICIPANTS: A total of 831 individuals with T-SCI or NT-SCI completed the Patient Health Questionnaire-9 (PHQ-9) and were included. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: The PHQ-9 was used to detect the presence of PMDD, and to measure the severity of the depression.
RESULTS: The most frequent etiology of SCI was T-SCI (66.9%). Overall, 16.2% of participants met the criteria for PMDD, though a higher prevalence was noted for NT-SCI individuals (21.1%) than for T-SCI individuals (13.8%). Risk factors between T-SCI and NT-SCI did not differ greatly. Female gender, chronic pain and lower levels of/difficulties in participation were associated with the presence of PMDD.
CONCLUSIONS: PMDD appears to occur at a higher rate in NT-SCI individuals, with greater symptom severity. The finding that problems with participation are directly associated with depression raises the need for specific treatment goals, with the aim of empowering individuals with SCI to reintegrate into the community. Potential stress factors, such as environmental barriers and limited participation options, should be addressed accordingly.