Depression and pain among inpatients with spinal cord injury and spinal cord disease: differences in symptoms and neurological function.
OBJECTIVE
To examine the relationship between depression and pain severity during inpatient rehabilitation for those with new onset of spinal cord injury or spinal cord disease (SCI/D), along with patient characteristics, neurological function and etiology.


METHODS
This cross-sectional study reviewed medical records of 100 adults with SCI/D including their admission scores on the Patient Health Questionnaire 9 (PHQ-9), a measure of depression, and pain ratings collected at admission and discharge.


RESULTS
Upon admission, 28% reported moderate-to-severe symptoms of depression and 69% reported pain. PHQ-9 scores were associated with pain only among those with the least severe impairments, for whom higher scores were associated with greater pain. While depression levels did not differ by etiology, those with traumatic injuries had higher pain ratings.


CONCLUSIONS
In general, depressive symptoms were not associated with pain severity in this sample. Etiology was associated with pain, those with traumatic SCI reporting more pain at admission. Among demographic characteristics, age was related to pain, with younger subjects reporting higher levels. These findings suggest that certain characteristics may predispose patients to pain and depression upon admission to rehabilitation. By determining who is at risk for these symptoms, clinicians can adopt treatments that prevent these from becoming chronic conditions.
U-M Spinal Cord Injury Model System, Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA. dgtate@umich.edu
Denise G
DG
Tate
Martin B
MB
Forchheimer
Dunia
D
Karana-Zebari
Anthony E
AE
Chiodo
Jennifer Young
JY
Kendall Thomas
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010146:Pain / Q000150:complications* / Q000209:etiology* / Q000523:psychology; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013118:Spinal Cord Diseases / Q000150:complications / Q000534:rehabilitation; D013119:Spinal Cord Injuries / Q000209:etiology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors