title: Trajectories and predictors of the course of mental health after spinal cord injury.
abstract: OBJECTIVE
  To study the course and predictors of mental health in the period between the start of active spinal cord injury (SCI) rehabilitation and 5 years after discharge. The hypothesis was that different mental health trajectories would be identified.
  
  
  METHODS
  Multicenter prospective cohort study with measurements at the start of active rehabilitation, after 3 months, at discharge, 1, 2, and 5 years after discharge.
  
  
  METHODS
  Eight Dutch rehabilitation centers with specialized SCI units.
  
  
  METHODS
  Persons (N=206) with recently acquired SCI aged between 18 and 65 years.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The 5-item Mental Health Index with a total score between 0 (lowest mental health) and 100 (highest mental health).
  
  
  RESULTS
  Levels of mental health increased between the start of active rehabilitation and 3 months later, remained stable thereafter, and increased again between 2 and 5 years after discharge. Latent class growth mixture modeling revealed 5 trajectories: (1) high scores (above 80) at all time-points (52%), (2) low scores (≤60) at all time-points (4%), (3) early recovery from 40 to scores above 70 (13%), (4) intermediate scores from 60 to scores above 70 (29%), and (5) severe deterioration of scores above 70 to scores below 30 (2%). Pain, sex, and education level were predictors to distinguish between the 5 trajectories.
  
  
  CONCLUSIONS
  Five different mental health trajectories were identified between the start of active rehabilitation and 5 years after discharge. About one third of the persons with SCI still perceived moderate to severe mental health problems 5 years after discharge. Pain, sex, and education level only predicted a small part of the variance in mental health trajectories.
authors: Swiss Paraplegic Research, Nottwil, Switzerland.
authors: Christel M
authors: CM
authors: van Leeuwen
authors: Trynke
authors: T
authors: Hoekstra
authors: Casper F
authors: CF
authors: van Koppenhagen
authors: Sonja
authors: S
authors: de Groot
authors: Marcel W
authors: MW
authors: Post
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012737:Sex Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D013997:Time Factors; D015599:Trauma Severity Indices