title: Psychological morbidity and spinal cord injury: a systematic review.
abstract: METHODS
  A systematic review of the literature concerning the nature of the psychological morbidity in people with spinal cord injury (SCI).
  
  
  OBJECTIVE
  SCI is believed to place the individual at a high risk of psychological morbidity. The objective of this paper was to examine systematically the prevalence of negative psychological states in people with SCI, as well as to explore mediating and contextual factors.
  
  
  METHODS
  Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as SCI, depression, anxiety and so on. Only studies that fulfilled certain criteria such as the use of valid measures in assessing psychological morbidity were used in the review process.
  
  
  RESULTS
  The systematic review revealed that clarification is still needed concerning the psychological consequences of people with SCI. However, findings suggest that approximately 30% of people with SCI are at risk of having a depressive disorder although in rehabilitation, and approximately 27% are at risk of having raised depressive symptoms when living in the community. The review also established that people with SCI have higher comparative risks of anxiety disorder, elevated levels of anxiety, feelings of helplessness and poor quality of life (QOL).
  
  
  CONCLUSIONS
  People with SCI have an increased risk of suffering debilitating levels of psychological morbidity. Future research needs to clarify the extent and nature of psychological morbidity following SCI by conducting prospective and comprehensive research in large heterogeneous samples of people with SCI during the rehabilitation phase and following reintegration into the community.
authors.affiliation: Rehabilitation Studies Unit, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia. a.craig@med.usyd.edu.au
authors.forename: A
authors.initials: A
authors.lastname: Craig
authors.forename: Y
authors.initials: Y
authors.lastname: Tran
authors.forename: J
authors.initials: J
authors.lastname: Middleton
mesh_terms: D001526:Behavioral Symptoms / Q000453:epidemiology*; D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D009017:Morbidity; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000523:psychology*