Depression following Traumatic Spinal Cord Injury

Dryden, Donna M; Saunders, L. Duncan; Rowe, Brian H.; May, Laura; Yiannakoulias, Niko; Svenson, Larry; Schopflocher, Donald; Voaklander, Donald C.

doi:10.1159/000086284

Cited by 118 publications

(94 citation statements)

References 55 publications

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“…Depression is common among SCI patients (Boekamp, et al, 1996, Dryden, et al, 2005, and selective serotonin re-uptake inhibitors (SSRI) such as fluoxetine (Prozac) and sertraline (Zoloft) are commonly prescribed anti-depressants (Goldberg, 1998). In cases of incomplete SCI where descending 5-HT fibers can be preserved (Lee, et al, 2005), these anti-depressants may cause an increase in the local concentration of serotonin in the lumbar spinal cord.…”

Section: Discussionmentioning

confidence: 99%

Up-regulation of 5-HT2 receptors is involved in the increased H-reflex amplitude after contusive spinal cord injury

Lee

Johnson

Wrathall

2007

Experimental Neurology

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The amplitude of the H-reflex increases chronically after incomplete SCI and is associated with the development of exaggerated hindlimb reflexes. Although the mechanism for this increased H-reflex is not clear, previous studies have shown that pharmacological activation of the 5-HT 2 receptors (5-HT 2 R) can potentiate the monosynaptic reflex. This study tested the hypothesis that increased expression of 5-HT 2 R on motoneurons is involved in increased H-reflex amplitude after a standardized clinically-relevant contusive SCI. Adult female rats were subjected to contusion, complete surgical transection, or a T8 laminectomy only. At 4wks after surgery, H-reflex recordings from the hindpaw plantar muscles of contused rats showed twice the amplitude of that in laminectomy controls or transected rats. To probe the role of 5-HT 2 R in this increased amplitude, dose response studies were done with the selective antagonists, mianserin or LY53857, and the 5-HT 2 R agonist, (±)-1-(2,5-Dimethoxy-4-iodophenyl)-2-aminopropane hydrochloride (DOI). The drugs were intrathecally infused into the lumbar cord while recording the H-reflex. Mianserin did not have any significant effects on the H-reflex after transection, consistent with the loss of distal serotonergic innervation. After contusion, both 5-HT 2 R antagonists reduced the H-reflex reflex amplitude with a significantly higher ID 50 compared to the uninjured controls. The 5-HT 2 R agonist, DOI, significantly increased reflex amplitude in contused but not control rats. Furthermore, while 5-HT immunoreactivity was similar, contused rats displayed increased 5-HT 2A R immunoreactivity in plantar muscle motoneurons compared to uninjured controls. We conclude that increased expression of 5-HT 2 R is likely to be involved in the enhanced H-reflex that develops after contusive SCI.

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Section: Discussionmentioning

confidence: 99%

Up-regulation of 5-HT2 receptors is involved in the increased H-reflex amplitude after contusive spinal cord injury

Lee

Johnson

Wrathall

2007

Experimental Neurology

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“…23,43,46,[53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70] These estimates are affected by the type of instruments, choice of cutoff point (for example, possible, probable and major) and sample characteristics (gender, age and time after SCI). Craig (2009) 5 found five studies that applied a structured diagnostic interview during the rehabilitation or hospitalization phase, reporting 20-43% having minor or major depression disorder.…”

Section: Methodsmentioning

confidence: 99%

Psychosocial issues in spinal cord injury: a review

2012

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Study design: Review. Objectives: To review literature on subjective well-being (SWB; mental health and life satisfaction) and on psychological and social support factors associated with these outcomes in people with spinal cord injury (SCI), in order to identify gaps in scientific knowledge and recommend research priorities. Setting: Non applicable. Methods: Narrative review of the SCI literature on life satisfaction and mental health (depression, anxiety, post-traumatic stress syndrome) outcomes in people with SCI. Further, reviews were performed of the SCI literature on psychological and social support variables associated with SWB and on psychosocial interventions aimed to improve SWB. Results: People with SCI experience, on average, higher levels of distress and lower levels of life satisfaction compared with the general population. Individual differences, however, are large, and most people with SCI adapt well to their condition. A set of psychological and social support factors is strongly related to SWB. Intervention studies on cognitive behavioural therapy or coping effectiveness training to improve SWB show promising results, but suffer from methodological weaknesses (for example, lack of randomization and small sample size). Conclusion: There is a need for cohort studies with sufficient sample size, which include people early after onset of SCI in order to enhance our understanding of the course of mental health and well-being after SCI. Cohort studies could also identify which people are at risk for long-term impairment of SWB. Finally, intervention studies on psychosocial interventions are needed to identify which interventions may improve SWB of people with SCI.

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“…1 Studies show elevated rates of MI among individuals with SCI, 2 others challenge this notion. In one study, two-thirds of the study sample did not exhibit depressive or anxiety symptoms.…”

Section: Introductionmentioning

confidence: 99%

Co-occurring medical and mental illness and substance use disorders among veteran clinic users with spinal cord injury patients with complexities

et al. 2009

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Study design: Longitudinal analysis of SCI registry merged with VHA administrative-data and Medicare claims files (FY1999-2002. Objectives: To estimate the prevalence of mental illness (MI) and substance use disorders (SUDs) among veteran health administration (VHA) clinic users with spinal cord injuries (SCI) and examine subgroup variations by demographic, socioeconomic characteristics, and duration and level of SCI. Setting: VHA clinic users (N ¼ 8338) with SCI who were alive by the end of FY2002. Methods: ICD-9-CM codes were used to identify individual MI (anxiety disorders, bipolar, depressive disorders, psychoses, post-traumatic stress disorder (PTSD) and schizophrenia) and categories of SUDs (tobacco, alcohol and drug abuse). Chi-square tests and multinomial logistic regression were used to examine the demographic and socio-economic profile of VHA users with SCI and MI and/or SUD. Results: Over a 2-year period, 46% VHA users with SCI had either a MI or SUDs: 20% had MI only; 12% had SUD only and 14% had both. The most common MI was depressive disorder (27%) and tobacco use was highly prevalent (19%). African-Americans (versus whites) were less likely to be diagnosed with MI only. Increased duration of SCI lowered the likelihood of MI and/or SUDs. Mood and anxiety disorders were highly prevalent in veterans with SCI with chronic physical conditions such as diabetes, heart disease, hypertension, and respiratory diseases. Conclusions: Mental illness and SUDs are highly prevalent in the VHA population with SCI and is complicated by the high rates of chronic physical conditions, presenting challenges in their healthcare management

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Depression following Traumatic Spinal Cord Injury

Cited by 118 publications

References 55 publications

Up-regulation of 5-HT2 receptors is involved in the increased H-reflex amplitude after contusive spinal cord injury

Up-regulation of 5-HT2 receptors is involved in the increased H-reflex amplitude after contusive spinal cord injury

Psychosocial issues in spinal cord injury: a review

Co-occurring medical and mental illness and substance use disorders among veteran clinic users with spinal cord injury patients with complexities

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