title: Prospective study of the occurrence of psychological disorders and comorbidities after spinal cord injury.
abstract: OBJECTIVE
  To conduct a prospective study of the occurrence of psychological disorders and comorbidities after spinal cord injury (SCI), determine psychotropic medication usage, and establish predictors of psychological disorders after transition to the community.
  
  
  METHODS
  Longitudinal design with multiple measures.
  
  
  METHODS
  Assessment occurred in SCI units and the community.
  
  
  METHODS
  Adults with SCI (N=88) admitted over a period of 32 months into 3 SCI units.
  
  
  METHODS
  Participants completed inpatient rehabilitation for an acute SCI. Longitudinal assessment occurred up to 6 months postdischarge.
  
  
  METHODS
  Measures were chosen that had a theoretical and clinical foundation for contributing to recovery after SCI. The Mini International Neuropsychiatric Interview, a structured diagnostic psychiatric interview, was conducted to determine the presence of psychological disorders. Medical measures included severity of secondary conditions or complications. Psychological measures included measures of anxiety and depressive mood, resilience, pain catastrophization, self-efficacy, and cognitive capacity.
  
  
  RESULTS
  Rates of psychological disorders of 17% to 25% were substantially higher than rates found in the Australian community. The occurrence of psychological disorder comorbidities was also very high. Anxiety was significantly elevated in those with a psychological disorder. Psychotropic medications were prescribed to more than 36% of the sample, with most being antidepressants. Factors predictive of psychological disorders included years of education, premorbid psychiatric/psychological treatment, cognitive impairment, secondary complications, resilience, and anxiety.
  
  
  CONCLUSIONS
  SCI can have a substantial negative impact on mental health that does not change up to 6 months postdischarge. Findings suggest a substantial minority experience increased psychosocial distress after the injury and after transitioning into the community. Additional resources should be invested in improving the mental health of adults with SCI.
authors.affiliation: John Walsh Center for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, New South Wales, Australia. Electronic address: a.craig@sydney.edu.au.
authors.forename: Ashley
authors.initials: A
authors.lastname: Craig
authors.affiliation: Australian College of Applied Psychology, Sydney, New South Wales, Australia; School of Social Sciences and Psychology, The University of Western Sydney, Sydney, New South Wales, Australia.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Nicholson Perry
authors.affiliation: John Walsh Center for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Guest
authors.affiliation: John Walsh Center for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, New South Wales, Australia; Key University Center for Health Technologies, University of Technology, Sydney, Sydney, New South Wales, Australia.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Tran
authors.affiliation: Spinal Cord Injury Unit, Prince of Wales Hospital, Randwick, New South Wales, Australia.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Dezarnaulds
authors.affiliation: Spinal Cord Injury Unit, Royal Rehabilitation Center, Sydney, Ryde, New South Wales, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Hales
authors.affiliation: Spinal Cord Injury Unit, Royal Rehabilitation Center, Sydney, Ryde, New South Wales, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Ephraums
authors.affiliation: John Walsh Center for Rehabilitation Research, Kolling Institute of Medical Research, Sydney Medical School-Northern, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Middleton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D003071:Cognition; D005260:Female; D006801:Humans; D007297:Inpatients; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008603:Mental Health; D008875:Middle Aged; D010146:Pain / Q000150:complications; D011446:Prospective Studies; D011788:Quality of Life; D055500:Resilience, Psychological; D020377:Self Efficacy; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000534:rehabilitation*; D013315:Stress, Psychological / Q000150:complications; D055815:Young Adult
keywords: Anxiety; Chronic pain; Depression; Mental disorders; Rehabilitation; Spinal cord injuries