title: Symptoms of depression over time in adults with pediatric-onset spinal cord injury.
abstract: OBJECTIVE
  To investigate the prevalence of depressive symptoms in adults with pediatric-onset spinal cord injury (SCI) and explore potential risk factors that may be associated with elevated symptoms.
  
  
  METHODS
  Longitudinal, cohort survey over a period of 2 to 9 years. Follow-up occurred approximately every year, a total of 868 interviews were conducted, and most participants contributed to at least 3 waves of data (72%; range, 2-8; mean, 4.34±2.16).
  
  
  METHODS
  Community.
  
  
  METHODS
  Adults (N=214; 133 men; mean age at first interview, 29.52±5.21y; range, 24-42y) who sustained an SCI prior to age 19 (mean age at injury, 13.93±4.37y; range, 0-18y). Participants tended to have complete injuries (71%) and tetraplegia (58%).
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Participants completed measures assessing psychosocial functioning, physical independence, participation, and depression at each time point. Multilevel growth modeling analyses were used to explore depression symptoms across time.
  
  
  RESULTS
  Depression symptoms at initial status were typically minimal (3.07±.24; 95% confidence interval, 2.6-3.54) but fluctuated significantly over time (P<.01). Several factors emerged as significant predictors of depressive symptoms in the final model, including less community participation (P<.01), incomplete injury (P=.02), hazardous drinking (P=.02), bladder incontinence (P=.01), and pain (P=.03). Within individuals, as bowel accidents (P<.01) and pain increased (P<.01), depression scores increased; however, marriage resulted in decreases in depression scores for individuals (P=.02).
  
  
  CONCLUSIONS
  These findings suggest that most patients with pediatric-onset SCI are psychologically resilient, but strategies to minimize secondary health complications and foster community participation and engagement should be considered.
authors: Shriners Hospitals for Children, Chicago, IL; Marquette University, Milwaukee, WI.
authors: Alicia M
authors: AM
authors: January
authors: Shriners Hospitals for Children, Chicago, IL; Loyola University, Chicago, IL. Electronic address: kzebracki@shrinenet.org.
authors: Kathy
authors: K
authors: Zebracki
authors: Shriners Hospitals for Children, Chicago, IL.
authors: Kathleen M
authors: KM
authors: Chlan
authors: Shriners Hospitals for Children, Chicago, IL; Rush Medical College, Chicago, IL.
authors: Lawrence C
authors: LC
authors: Vogel
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000453:epidemiology*; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D010372:Pediatrics; D015995:Prevalence; D011782:Quadriplegia / Q000453:epidemiology; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D058992:Social Participation; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000523:psychology*; D013997:Time Factors; D015599:Trauma Severity Indices
keywords: Depression; Longitudinal studies; Pediatrics; Rehabilitation; Spinal cord injuries