Article

OBJECTIVE: To study the course and predictors of mental health in the period
between the start of active spinal cord injury (SCI) rehabilitation and 5 years
after discharge. The hypothesis was that different mental health trajectories
would be identified. DESIGN: Multicenter prospective cohort study with
measurements at the start of active rehabilitation,
after 3 months, at discharge,
1, 2, and 5 years after discharge. SETTING: Eight Dutch rehabilitation centers
with specialized SCI units. PARTICIPANTS: Persons (N=206) with recently acquired
SCI aged between 18 and 65 years. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURE: The 5-item Mental Health Index with a total score between 0 (lowest
mental health) and 100 (highest mental health). RESULTS: Levels of mental health
increased between the start of active rehabilitation and 3 months later, remained
stable thereafter, and increased again between 2 and 5 years after discharge.
Latent class growth mixture modeling revealed 5 trajectories: (1) high scores
(above 80) at all time-points (52%), (2) low scores (</=60) at all time-points
(4%), (3) early recovery from 40 to scores above 70 (13%),
(4) intermediate
scores from 60 to scores above 70 (29%), and (5) severe deterioration of scores
above 70 to scores below 30 (2%). Pain, sex, and education level were predictors
to distinguish between the 5 trajectories. CONCLUSIONS: Five different mental
health trajectories were identified between the start of active rehabilitation
and 5 years after discharge. About one third of the persons with SCI still
perceived moderate to severe mental health problems 5 years after discharge.
Pain, sex, and education level only predicted a small part of the variance in
mental health trajectories.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS