Article

OBJECTIVE: To conduct a prospective study of the occurrence of psychological
disorders and comorbidities after spinal cord injury (SCI), determine
psychotropic medication usage, and establish predictors of psychological
disorders after transition to the community.
DESIGN: Longitudinal design with
multiple measures. SETTING: Assessment occurred in SCI units and the community.
PARTICIPANTS: Adults with SCI (N=88) admitted over a period of 32 months into 3
SCI units. INTERVENTIONS: Participants completed inpatient rehabilitation for an
acute SCI. Longitudinal assessment occurred up to 6 months postdischarge. MAIN
OUTCOME MEASURES: Measures were chosen that had a theoretical and clinical
foundation for contributing to recovery after SCI. The Mini International
Neuropsychiatric Interview, a structured diagnostic psychiatric interview, was
conducted to determine the presence of psychological disorders. Medical measures
included severity of secondary conditions or complications. Psychological
measures included measures of anxiety and depressive mood, resilience, pain
catastrophization, self-efficacy, and cognitive capacity. RESULTS: Rates of
psychological disorders of 17% to 25% were substantially higher than rates found
in the Australian community.
The occurrence of psychological disorder
comorbidities was also very high. Anxiety was significantly elevated in those
with a psychological disorder. Psychotropic medications were prescribed to more
than 36% of the sample, with most being antidepressants. Factors predictive of
psychological disorders included years of education, premorbid
psychiatric/psychological treatment, cognitive impairment, secondary
complications, resilience, and anxiety. CONCLUSIONS:
SCI can have a substantial
negative impact on mental health that does not change up to 6 months
postdischarge. Findings suggest a substantial minority experience increased
psychosocial distress after the injury and after transitioning into the
community. Additional resources should be invested in improving the mental health
of adults with SCI.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS