Psychosocial Consequences of Spinal Cord Injury: A Narrative Review

Abstract

Consequences of a spinal cord injury (SCI) entail much more than damage to the spinal cord. The lives of people with SCI, along with those around them, experience profound long-lasting changes in nearly every life domain. SCI is a physical (biological) injury that is inextricably combined with various psychological and social consequences. The objective of this review is to present psychosocial challenges following SCI through the biopsychosocial model, beginning with acknowledgement of the larger societal effects of ableism and stigma before addressing the many unique psychosocial aspects of living with SCI. Included in this review are qualitative studies and systematic reviews on current psychosocial outcomes and consequences. This paper attempts to structure this information by dividing it into the following sections: relationships and family; changes in finances and employment; issues related to the person’s living situation; community reintegration; factors associated with mood and coping (e.g., depression, anxiety, substance use, and PTSD); self-harm behaviors (ranging from nonadherence to suicide); effects of traumatic brain injury; considerations regarding sexual health; aging with SCI; and concludes with a brief discussion about post-traumatic growth. Cultivating an understanding of the unique and interrelated psychosocial consequences of people living with SCI may help mitigate the psychosocial aftermath and serve as a reminder to providers to maintain a person-centered approach to care.

International Classification of Function, Disability and Health (ICF) Word Mapping to Determine the Human Functioning Associated with Upper Extremity Surgery for Tetraplegia

“…[29][30][31] However, the ICF does explore the extent to which human functioning is considered within outcome measures , and as such provides a repeatable systematic evaluation. Given what we know about psychosocial consequences and demands of living with SCI, 32,33 the coverage of human functioning excluded Chapter 1 (d) Mental functions unless the patient lived-experience data was viewed. This is particularly important given recent work from our broader research group on SCI in relation to cognition and psychosocial adjustment.…”

Role of NLRP3 Inflammasome in Post-Spinal-Cord-Injury Anxiety and Depression: Molecular Mechanisms and Therapeutic Implications

“…10 Within 3 months of the injury, approximately 63% of SCI patients were observed to suffer from major depressive disorder (MDD), 20 which can last for more than 10 years. 21 Untreated MDD in patients with SCI can have detrimental effects on their quality of life and hinder their return to functioning at a normal level. 22 Additionally, it is linked to long-term adverse effects, including an increased risk of secondary medical conditions such as decubitus ulcers and recurrent urinary tract infections.…”

“…A considerable proportion of SCI patients, up to 45%, experience heightened levels of fear, worry, or panic, which subsequently raises their susceptibility to developing anxiety-related disorders . Within 3 months of the injury, approximately 63% of SCI patients were observed to suffer from major depressive disorder (MDD), which can last for more than 10 years . Untreated MDD in patients with SCI can have detrimental effects on their quality of life and hinder their return to functioning at a normal level .…”

Letter: Appraising the Recent Management Gaps for Spinal Cord Injuries in Low-Resource Settings: The Case of Sub-Saharan African Countries

“…1,2 Some patients with SCI are usually unwilling to present to hospital, even if they have supportive families because of the long-term psychosocial effects of their injury, leading to uncooperative behaviors such as refusing medication, hospital visits, and subsequent care. 13 Thus, some SCI patients' families leave their patients in the hands of traditional healers in mostly impoverished areas with little access to specialized spinal health care.…”