Indicators of psychological distress in postacute spinal cord injured individuals

Spinal Cord. 2005 Apr;43(4):223-9. doi: 10.1038/sj.sc.3101703.

Abstract

Study design: Consecutive inclusion of spinal cord injured patients admitted for postacute rehabilitation from June 2000 to January 2002.

Objective: Assessment of prevalence of indicators of psychological distress in the subacute and early chronic stages after acute-onset spinal cord injury (SCI).

Setting: A Swedish rehabilitation center.

Methods: In all, 36 patients participated. Psychological assessment was obtained at admission, discharge and 6 months follow-up by psychological measures based on the DSM-IV (ie Beck's Depression Inventory, SPIFA, SCID-screen, AUDIT) and clinical interview. Ongoing psychotropic medication was noted.

Results: Clinical depression was infrequent. However, ongoing psychotropic medication was common, possibly indicating a relatively high incidence of underlying depressive and anxiety disorders. In all, 25% of the sample showed indicators of high alcohol consumption. Few patients had a previously diagnosed personality disorder. By contrast, there was frequent occurrence of personality traits outside normal ranges.

Conclusion: Medication of psychological problems commonly occurs after SCI, especially for depression and anxiety. There are indications of alcohol overconsumption in a substantial minority of SCI patients. The study raises the question of whether suppression of psychological symptoms by drug therapy is the optimal treatment of such problems in a rehabilitation process.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alcoholism / etiology
  • Antidepressive Agents / therapeutic use
  • Anxiety / drug therapy
  • Anxiety / etiology
  • Anxiety / prevention & control
  • Anxiety / psychology
  • Depressive Disorder / drug therapy
  • Depressive Disorder / etiology
  • Depressive Disorder / prevention & control
  • Depressive Disorder / psychology*
  • Female
  • Follow-Up Studies
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Neurologic Examination
  • Outcome Assessment, Health Care*
  • Personality Inventory / statistics & numerical data
  • Predictive Value of Tests
  • Psychiatric Status Rating Scales
  • Psychological Tests / statistics & numerical data
  • Retrospective Studies
  • Spinal Cord Injuries / complications
  • Spinal Cord Injuries / drug therapy
  • Spinal Cord Injuries / psychology*
  • Spinal Cord Injuries / rehabilitation
  • Time Factors
  • Trauma Severity Indices

Substances

  • Antidepressive Agents