Abstract
Objective
To determine the number and type of longitudinal depression trajectories during the
first year after spinal cord injury (SCI) and to identify baseline predictors of these
trajectories.
Design
Cohort study.
Setting
Rehabilitation and postacute community settings.
Participants
Of 168 consecutive admissions to inpatient rehabilitation for acute SCI, 141 (115
men, 26 women) patients were enrolled in a randomized controlled trial telephone follow-up
intervention, which showed no outcome differences, and completed assessments on at
least 2 of the 4 follow-up occasions (3, 6, 9, and 12 months after SCI). Participants
were on average 41 years old, most were non-Hispanic (96%) and white (86%), and 61.7%
had tetraplegia.
Interventions
Data were drawn from the ineffective randomized controlled trial.
Main Outcome Measure
Patient Health Questionnaire-9 (PHQ-9).
Results
Unconditional linear latent class growth analysis models of PHQ-9 total scores revealed
an optimal 3-class solution: stable low depression (63.8%), mild to moderate depression
(29.1%), and persistent moderate to severe depression (7.1%). Preinjury mental health
history and baseline pain, quality of life, and grief predicted class membership.
Conclusions
The modal response to SCI was stable low depression, whereas persistent moderate to
severe depression primarily represented a continuation or relapse of preinjury depression.
This line of research has the potential to improve identification of subgroups destined
for poor outcomes and to inform early intervention studies.
Keywords
List of abbreviations:
PHQ-9 (Patient Health Questionnaire-9), SCI (spinal cord injury)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: October 22, 2015
Footnotes
Supported by the Department of Education, National Institute on Disability and Rehabilitation Research, Spinal Cord Injury Model Systems (grant nos. H133N060033 and H133N110009) and the National Institute on Aging (grant no. 5T32AG027677).
Disclosures: none.
Identification
Copyright
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
