Prevalence of depression diagnoses and use of antidepressant medications by veterans with spinal cord injury.
OBJECTIVE
The objectives of this study were to examine the prevalence of depression diagnoses among veterans with spinal cord injuries and disabilities (SCI&D) for a 3-yr period, and to characterize patterns of antidepressant medication use in this population.


METHODS
This study was a retrospective analysis of clinical and administrative data. The sample consisted of 3678 veterans with SCI&D who had received any health care at a Department of Veterans Affairs facility between fiscal years 1999 and 2001, a depression diagnosis, and complete data. Logistic regression analysis was used to examine associations between patient characteristics, antidepressant types, and prescription patterns.


RESULTS
Approximately 22% of veterans with SCI&D received a diagnosis of depression during at least one encounter with a healthcare provider. Of those diagnosed, 72% received antidepressant prescriptions. However, a large percentage (67%) did not continue antidepressant use for 6 mos. Patients started on a selective serotonin reuptake inhibitor were more likely to have at least 6 mos of continuous use than patients started on other, newer antidepressants.


CONCLUSIONS
Many veterans with SCI&D may not be receiving adequate treatment for depression. Veterans with SCI&D should be aggressively screened and treated for depression, and further research is necessary to determine which treatments for depression are most effective for persons with SCI&D.
Center for Management of Complex Chronic Care and VA Spinal Cord Injury Quality Research Initiative, Hines VA Hospital, Hines, Illinois 60141, USA.
Bridget M
BM
Smith
Frances M
FM
Weaver
Philip M
PM
Ullrich
D000368:Aged; D000928:Antidepressive Agents; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D004363:Drug Utilization; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012189:Retrospective Studies; D017367:Selective Serotonin Reuptake Inhibitors; D013119:Spinal Cord Injuries / Q000523:psychology*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors