Psychological investigation of spinal cord injury patients

Abstract

Spinal cord injuries (SCI) often have psychological consequences, primarily anxiety and depression, which may interfere with rehabilitation possibilities, with adjustment to the impairment and therefore with the possibility of returning to previous familiar social life and work. To assess the degree of anxiety and depression in SCI patients, and to study the factors contributing to their genesis, 100 SCI in-and out-patients were administered questionnaires for self-rating anxiety and depression. A group of newly injured patients was followed up for a year after their discharge to study the evolution of the two psychological syndromes. These two psychological pathologies in SCI patients were respectively 13% (anxiety) and 16% (depression). Some characteristics were signi®cantly associated with a higher risk of developing psychological distress: the presence of severe complications, the lack of autonomy, and low educational level. We did not observe any modi®cation of the psychological picture over time. The lack of reduction in anxiety and depression over time could mean that the two pathologies are maintained by the obstacles SCI patients meet every day resulting from their neurological de®cit. Our data justify the provision of psychological services for SCI patients in the rehabilitation centres; these services should still be available to the patients even after discharge.

Anxiety prevalence following spinal cord injury: a meta-analysis

“…Notably, accommodations were made for the STAI, with elevated cutoff scores for self-reported 'clinical caseness' utilised in an attempt to improve test specificity and, in turn, achieve reliable estimates of anxiety prevalence. 12,27,37 The STAI is considered a comprehensive 40-item scale that has demonstrated applicability in populations with chronic conditions. 12 Further research is, however, still needed to confirm the utility of proposed cutoff scores.…”

“…The full-texts of these studies were subsequently examined by both authors. 1,8,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] The reference lists of these studies and published SCI review papers 2,10,11,41 were additionally examined. Although this process did not lead to the discovery of any new studies, it helped ensure that all relevant papers were identified.…”

“…Clinically significant 'cases' of self-reported anxiety ranged from 15% (STAI) to 32% (DASS-21): these differences were significant (that is, CIs did not overlap; Figure 4). The most frequently used scale was the Hospital Anxiety and Depression Scale (HADS-A; anxiety subscale), with studies consistently using the proposed cutoff 37 ) and 48, 27 respectively. January et al 26 noted a comparable rate of current anxiety prevalence (29.2%), based on the BAI, and lifetime prevalence (29%) based on self-reported treatment history.…”

Screening for depression and anxiety in spinal cord injury with DASS-21

“…The incidence of anxiety and depression in SCI exceeds that of the general population, with psychological morbidity or psychological distress estimates ranging between 20 and 30%, suggesting the need for appropriate screening tools in these patients. [4][5][6][7] Most measures used to assess depression and anxiety in patients with SCI were standardized on people without physical disabilities or chronic medical conditions. 8 Importantly, incidence rates of depression in SCI are higher when based on self-report measures than when based on structured interviews.…”

Re-examining the psychology of spinal cord injury: a meaning centered approach from a cultural perspective

“…1,2 This burden, if excessive, may lead to emotional break-down among people with SCI. Despite the last few decades having witnessed an increase in literature regarding psychological reaction to people with SCI 3,4 and their carers 5 ± 7 there is a paucity of studies on individual conceptions of the experience of SCI. However, the few studies that address these individual conceptions of the experience of SCI are based on Western European perspective.…”