Psychological distress following spinal cord injury

Abstract

Introduction

There is limited data on psychological burden following spinal cord injury (SCI) in Singapore.

Aims

(1) To describe the prevalence of depression and anxiety at admission for inpatient rehabilitation and (2) describe the baseline characteristics that predict the development of anxiety or depression in patients following SCI.

Methodology

We retrospectively reviewed medical records of SCI patients at admission from 01-06-2013 to 31-12-2015. The Hospital Anxiety and Depression Scale (HADS), ASIA score and demographics were collated.

Results

A total of 157 subjects were included, 62.4% (n = 98) were male with a mean age of 56.7 years. 43.4% (n = 68) had a traumatic SCI with 73.9% (n = 116) having had spinal surgery. The average length of stay was 46.6 days with most discharged to their own homes. Ten subjects screened positive for anxiety (6.4%) and 16 for depression (10.2%). 13.4% (n = 21) screened positive for anxiety and/or depression. Two third (n = 95) had injuries at the cervical level and 14% (n = 22) scored ASIA A/B. 45.9% (n = 72) was referred to the psychologist. A significantly higher proportion of subjects (P < 0.05) who screened positive had a past psychiatric history, were prescribed antidepressants at admission and during rehabilitation. Significant differences were noted in primary caregiver (nursing home vs. others) following discharge when comparing those that screened positive vs. negative however there were no significant differences between baseline demographics, neurological level and ASIA score.

Conclusion

Psychological burden following SCI is significant. Standardized screening and psychological support is warranted with special attention to those with a past psychiatric history.

Disclosure of interest

The authors have not supplied their declaration of competing interest.