Post-traumatic stress disorder among individuals with traumatic spinal cord injury in Nepal: a cross-sectional study

Abstract

Study design: Cross-sectional studyObjectives: To identify the prevalence of posttraumatic stress disorder (PTSD) among the individuals with traumatic spinal cord injury (TSCI) and to examine the relationships between demographic and clinical characteristics, and PTSD.Setting: Spinal Injury Rehabilitation Center (SIRC) and Dhulikhel Hospital, Kathmandu University Hospital (DH, KUH), Kavrepalanchowk, Nepal.Methods: Individuals above18 years of age with TSCI of at least one month from trauma and admitted to SIRC and DH, KUH from June 2019 to May 2021 were included. The specific stress version of the Post-Traumatic Stress Disorder Checklist (PCL), a 17- item self-report instrument corresponding to DSM–IV criteria for PTSD was utilized. To classify the neurological status of TSCI individuals, American Spinal Cord Injury Association (ASIA) and International Standard for Neurological Classification of Spinal Cord Injury (ISNCSCI) were used. Hierarchical multiple regression analysis between independent variables and normalized PCL score was done to evaluate the predictors of PTSD.Results: Among 163 patients, the overall prevalence of PTSD was 27%, and the mean PCL score was 36±13.9. Factors predictive of PTSD included gender, family type, ethnicity, and literacy rate. No significant association was found between the clinical characteristics and PTSD.Conclusions: PTSD appears to be considerably prevalent among individuals with TSCI in Nepal. Females, individuals from nuclear families, individuals with lower literacy, and individuals from lower caste are significantly vulnerable to developing PTSD. However, clinical characteristics do not appear to be influential in the development of PTSD.