Depression following traumatic spinal cord injury.
OBJECTIVE
To describe the epidemiology of depression following traumatic spinal cord injury (SCI) and identify risk factors associated with depression.


METHODS
This population-based cohort study followed individuals from date of SCI to 6 years after injury. Administrative data from a Canadian province with a universal publicly funded health care system and centralized databases were used. A Cox proportional hazards model was developed to identify risk factors.


RESULTS
Of 201 patients with SCI, 58 (28.9%) were treated for depression. Individuals at highest risk were those with a pre-injury history of depression [hazard rate ratio (HRR) 1.6; 95% CI: 1.1-2.3], a history of substance abuse (HRR 1.6; 95% CI: 1.2-2.3) or permanent neurological deficit (HRR 1.6; 95% CI: 1.2-2.1).


CONCLUSIONS
Depression occurs commonly and early in persons who sustain an SCI. Both patient and injury factors are associated with the development of depression. These should be used to target patients for mental health assessment and services during initial hospitalization and following discharge into the community.
Dryden
Donna M
DM
British Columbia Rural and Remote Health Research Institute, University of Northern British Columbia, Prince George, BC, Canada. ddryden@ualberta.ca
Saunders
L Duncan
LD
Rowe
Brian H
BH
May
Laura A
LA
Yiannakoulias
Niko
N
Svenson
Lawrence W
LW
Schopflocher
Donald P
DP
Voaklander
Donald C
DC
D000328:Adult; D002170:Canada / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000523:psychology*; D014947:Wounds and Injuries