Post-traumatic stress disorder symptoms and pain intensity in persons with spinal cord injury

Abstract

Study design Cross-sectional.Objectives To examine the association between post-traumatic stress disorder (PTSD) symptoms and pain intensity, taking symptoms of anxiety and depression into account within persons with spinal cord injury (SCI). Setting Persons with SCI, who visited a Dutch rehabilitation centre between 2005 and 2010, were invited to complete a survey. Methods PTSD symptoms were measured with the Trauma Screening Questionnaire (TSQ), pain intensity with an 11-point Numerical Rating Scale (NRS), and symptoms of anxiety and depression with the Hospital Anxiety and Depression Scale (HADS). To determine associations between PTSD symptoms and pain intensity, linear regression analyses were performed. Confounding variables representing anxiety and depression were added to the final model. Results In total, 175 participants (55.8% traumatic, 29.1% complete) were included (response rate of 31.7%). Of them, 11.4% had clinically relevant symptoms of probable PTSD (TSQ score ≥ 6) 69.8% experienced moderate to severe pain levels (NRS ≥ 4), 14.9% had symptoms of anxiety and 20.8% symptoms of depression (HADS scores ≥ 11). Levels of PTSD symptoms were strongly associated with symptoms of anxiety (0.54) and depression (0.49). Bivariate analyses showed a moderate significant association (0.30) between PTSD symptoms and pain intensity. This association became small (0.10) when anxiety and depression comorbidity were factored into the final regression model. Conclusions No independent association between PTSD symptoms and pain intensity was shown when adjusted for anxiety and depression. Results of this study suggest the usefulness of screening for PTSD in persons with SCI (regardless of injury cause or type/level) who score high on symptoms of anxiety/depression.

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

“…al. where individuals having higher PTSD symptoms were from primary/lower education background than with higher education [24]. Similarly, Tang et.…”

Psychological Screening, Standards and Spinal Cord Injury: Introducing Change in NHS England Commissioned Services

“…This may include, as two of the SCICs in the current study demonstrated, MDT colleagues administering psychological health screening. As identified in the Netherlands, screening enhanced non-psychologist rehabilitation members' appreciation of psychological issues [21]. Bombardier et al's (2021) comprehensive overview of screening and intervention includes guidance regarding how MDT colleagues can structure rehabilitation for those identified with mood difficulties and are highly applicable when qualified psychological resources are lacking [14].…”

“…The Netherlands commenced psychological screening in 2018, with inpatients being administered a range of brief measures within two weeks of admission as an inpatient or on commencing an outpatient rehabilitation programme. The programme aimed to evaluate 80% of the people identified; however, an audit found that due to staffing constraints and logistics, only 64% of patients completed the measures [21]. Developed as part of the screening, the programme adopted a national approach of flagging those needing follow-up, with patient responses on each measure being RAG (red, amber, green) rated.…”

“…Developed as part of the screening, the programme adopted a national approach of flagging those needing follow-up, with patient responses on each measure being RAG (red, amber, green) rated. Several benefits of screening were identified: timely recognition of psychological problems; screening measures, as administered by a psychologist, providing an introduction to broader psychosocial issues regarding self-efficacy and resilience rather than just a pathological focus; screening enabling more targeted treatment and use of personnel; and, of perhaps greatest significance, increased identification and recognition of psychological issues amongst other rehabilitation team members [21].…”

Digital psychosocial interventions for individuals with spinal cord injury: a scoping review

“…Spinal cord injury (SCI) poses great psychosocial challenges for the person affected and requires a long-lasting adaptation process which is reflected, among other things, in an above-average mental morbidity (1)(2)(3)(4)(5). Social support in the sense of the bio-psycho-social model plays a major role in coping processes (6).…”