title: Relationship Between Depressive State and Treatment Characteristics of Acute Cervical Spinal Cord Injury in Japan.
abstract: BACKGROUND
  Few studies have assessed whether treatment of acute cervical spinal cord injury (SCI) patients contributes to depression.
  
  
  METHODS
  Using an administrative database, we assessed patients for whom the diagnosis was unspecified injuries of cervical spinal cord (International Classification of Diseases and Injuries-10th (ICD-10) code; S14.1). We categorized patients with codes for depressive episode (ICD-10 code; F32) or recurrent depressive disorder (F33), or those prescribed antidepressants (tricyclic, tetracyclic, Selective Serotonin Reuptake Inhibitors, Serotonin Noradrenaline Reuptake Inhibitors, Trazodone, Sulpiride, or Mirtazapine) as having a depressive state. We compared the rate of each acute treatment between the depressive state group and the non-depressive state group using chi-square tests, and a multiple logistic regression model was used to identify the association between the acute treatment and depressive state.
  
  
  RESULTS
  There were 151 patients who were judged to be in a depressive state, and the other 2115 patients were categorized into the non-depressive state group. Intervention of intravenous anesthesia, tracheostomy, artificial respiration, and gastrostomy had a significant positive correlation with depressive state. Multiple logistic regression analysis showed that tracheostomy (odds ratio [OR] 2.18; 95% confidence interval [CI], 1.09-4.38) and artificial respiration (OR 2.28; 95% CI, 1.32-3.93) were significantly associated with depressive state, and men had a 36% reduction in the risk of depressive state compared with women (OR 0.64; 95% CI, 0.44-0.94), whereas age, wound-treatment, all of the orthopedic procedures, intravenous anesthesia, and gastrostomy were not associated with depressive state.
  
  
  CONCLUSIONS
  These findings suggest that tracheostomy, artificial respiration and female gender in the acute phase after cervical SCI might be associated with the development of depression.
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health.
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Matsuda
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Kubo
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fujino
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsuda
authors.forename: Futoshi
authors.initials: F
authors.lastname: Wada
authors.forename: Atsuko
authors.initials: A
authors.lastname: Sugita
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000523:psychology / Q000628:therapy*; D055815:Young Adult