title: Association of internet use and depression among the spinal cord injury population.
abstract: OBJECTIVE
  To examine the relation between the frequency of Internet use and depression among people with spinal cord injury (SCI).
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  SCI Model Systems.
  
  
  METHODS
  People with SCI (N=4618) who were interviewed between 2004 and 2010.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The frequency of Internet use and the severity of depressive symptoms were measured simultaneously by interview. Internet use was reported as daily, weekly, monthly, or none. The depressive symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9), with 2 published criteria being used to screen for depressive disorder. The diagnostic method places more weight on nonsomatic items (ie, items 1, 2, and 9), and the cut-off method that determines depression by a (PHQ-9) score ≥10 places more weight on somatic factors. The average scores of somatic and nonsomatic items represented the severity of somatic and nonsomatic symptoms, respectively.
  
  
  RESULTS
  Our multivariate logistic regression model indicated that daily Internet users were less likely to have depressive symptoms (odds ratio=.77; 95% confidence interval, .64-.93), if the diagnostic method was used. The linear multivariate regression analysis indicated that daily and weekly Internet usage were associated with fewer nonsomatic symptoms; no significant association was observed between daily or weekly Internet usage and somatic symptoms.
  
  
  CONCLUSIONS
  People with SCI who used the Internet daily were less likely to have depressive symptoms.
authors: School of Public Health, University of Texas Health Science Center at Houston, Houston, TX. Electronic address: I-Hsuan.Tsai@uth.tmc.edu.
authors: I-Hsuan
authors: IH
authors: Tsai
authors: Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX.
authors: Daniel E
authors: DE
authors: Graves
authors: School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors: Ching-Huang
authors: CH
authors: Lai
authors: School of Public Health, University of Texas Health Science Center at Houston, Houston, TX.
authors: Lu-Yu
authors: LY
authors: Hwang
authors: School of Public Health, University of Texas Health Science Center at Houston, Houston, TX.
authors: Lisa A
authors: LA
authors: Pompeii
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D010147:Pain Measurement; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000523:psychology*
keywords: AIS; ASIA Impairment Scale; CI; Depression; Internet; NSCID; National Spinal Cord Injury Database; OR; PHQ-9; Patient Health Questionnaire-9; Rehabilitation; SCI; Spinal cord injuries; confidence interval; odds ratio; spinal cord injury