title: Depression following traumatic spinal cord injury.
abstract: 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.
authors.affiliation: British Columbia Rural and Remote Health Research Institute, University of Northern British Columbia, Prince George, BC, Canada. ddryden@ualberta.ca
authors.forename: Donna M
authors.initials: DM
authors.lastname: Dryden
authors.forename: L Duncan
authors.initials: LD
authors.lastname: Saunders
authors.forename: Brian H
authors.initials: BH
authors.lastname: Rowe
authors.forename: Laura A
authors.initials: LA
authors.lastname: May
authors.forename: Niko
authors.initials: N
authors.lastname: Yiannakoulias
authors.forename: Lawrence W
authors.initials: LW
authors.lastname: Svenson
authors.forename: Donald P
authors.initials: DP
authors.lastname: Schopflocher
authors.forename: Donald C
authors.initials: DC
authors.lastname: Voaklander
mesh_terms: 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