Association Between Depression and Chronic Complications in Clients With Traumatic Spinal Cord Injury

  • Mahsa Ghajarzadeh Department of Neurosurgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
  • Hooshang Saberi Brain and Spinal Cord Injury Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Keywords: Spinal cord injury, Complications, Iran

Abstract

The aim of this study was to evaluate the association between depression and chronic complications, in clients with traumatic spinal cord injury (TSCI). Eight hundred and thirty Traumatic Spinal Cord Injury (TSCI) patients were enrolled in this study. All cases filled up the Valid and Reliable Persian version of the Beck Depression Inventory (BDI). Each patient was examined by a constant neurosurgeon, and a TSCI research fellow to determine the level of injury, AIS (ASIA impairment scale) grade, and chronic complications. Eight hundred and thirty individuals participated in the study. Mean Spinal Cord Independence Measure (SCIM) score was 57.5±20 in cases with BDI<10, while it was 57.2±15.6 in patients with 9<BDI<19, 55.5±16.3 in cases with 19≤BDI<30 and 52.3±14.9 in cases with BDI≥30 (P=0.02). Also, the prevalence of pressure ulcers, neuropathic pain, spasm, suicide attempts, and sexual dysfunction were significantly higher among cases with major depression (BDI≥30). Mean visual analogue scale (VAS) was significantly higher and mean SCIM was significantly lower in patients with BDI≥30. There was a significant negative correlation between SCIM and BDI scores (r=-0.5, P=0.004) and significant positive correlation between VAS and BDI (r=0.65, P=0.04). Depression is an important risk factor in patients with TSCI for development of secondary complications. Chronic complications and greater functional dependency were observed more frequently in cases with BDI≥10.

References

1. Pickett W, Simpson K, Walker J, Brison RJ. Traumatic spinal cord injury in Ontario, Canada. J Trauma Acute Care Surg 2003;55:1070-6.
2. Vasiliadis AV. Epidemiology map of traumatic spinal cord injuries: A global overview. Int J Caring Sci 2012;5:335-47.
3. Dudley-Javoroski S, Shields RK. Assessment of physical function and secondary complications after complete spinal cord injury. Disabil Rehabil 2006;28:103-10.
4. Derakhshanrad N, Yekaninejad M, Vosoughi F, Fazel FS, Saberi H. Epidemiological study of traumatic spinal cord injuries: experience from a specialized spine center in Iran. Spinal Cord 2016;54:901-7.
5. Sezer N, Akkuş S, Uğurlu FG. Chronic complications of spinal cord injury. World J Orthop 2015;6:24-33.
6. Craig A, Tran Y, Middleton J. Psychological morbidity and spinal cord injury: a systematic review. Spinal Cord 2009;47:108-14.
7. Carter SL. Themes of grief. Nurs Res 1989;38:354-8.
8. Yazdanshenas Ghazwin M, Kavian M, Ahmadloo M, Jarchi A, Golchin Javadi S, Latifi S et al. The Association between Life Satisfaction and the Extent of Depression, Anxiety and Stress among Iranian Nurses: A Multicenter Survey. Iran J Psychiatry 2016;11: 120-7.
9. Elliott TR, Kennedy P. Treatment of depression following spinal cord injury: an evidence-based review. Rehabil Psychol 2004;49:134.
10. Lu TH, Chiang T, Lynch J. What can we learn from international comparisons of social inequalities in road traffic injury mortality? Inj Prev 2005;11:131-3.
11. Vafa Rahimi-Movaghar M. Efficacy of surgical decompression in the setting of complete thoracic spinal cord injury. J Spinal Cord Med 2005;28:415-20.
12. Javadi M, Hafezi-Nejad N, Vaccaro AR, Rahimi-Movaghar V. Medical complications and patient outcomes in Iranian veterans with spinal cord injury. Adv Clin Exp Med 2013;23:269-75.
13. Pressure NPUAPN, ulcer UAPNgfp. (Accessed August 2018, 10, at http://www.npuap.org/pr2.htm sAa).
14. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian‐language version of the Beck Depression Inventory‐Second edition: BDI‐II‐PERSIAN. Depress Anxiety 2005;21:185-92.
15. Sadeghi M, Sawatzky B. Effects of vibration on spasticity in individuals with spinal cord injury: a scoping systematic review. Am J Phys Med Rehabil 2014;93:995-1007.
16. McKinley WO, Jackson AB, Cardenas DD, Michael J. Long-term medical complications after traumatic spinal cord injury: a regional model systems analysis. Arch Phys Med Rehabil 1999;80:1402-10.
17. Razavi SZE, Aryan A, Kazemi S, Rostamian A, Jahangiri A, Ghajarzadeh M. Prevalence of Hip Ossification and Related Clinical Factors in Cases With Spinal Cord Injury. Arch Neurosci 2015;2:1.
18. Do JG, Kim DH, Sung DH. Incidence of deep vein thrombosis after spinal cord injury in Korean patients at acute rehabilitation unit. J Korean Med Sci 2013;28:1382-7.
19. Johnson RL, Brooks CA, Whiteneck GG. Cost of traumatic spinal cord injury in a population-based registry. Spinal Cord 1996;34:470-80.
20. Geyh S, Nick E, Stirnimann D, Ehrat S, Michel F, Peter C et al. Self-efficacy and self-esteem as predictors of participation in spinal cord injury—an ICF-based study. Spinal Cord 2012;50:699-706.
21. Munce S, Straus S, Fehlings MG, Voth J, Nugaeva N, Jang E, et al. Impact of psychological characteristics in self-management in individuals with traumatic spinal cord injury. Spinal Cord 2016;54:29-33.
22. Munce SE, Webster F, Fehlings MG, Straus SE, Jang E, Jaglal SB. Perceived facilitators and barriers to self-management in individuals with traumatic spinal cord injury: a qualitative descriptive study. BMC Neurol 2014;14:48.
23. Suzuki R, Krahn GL, McCarthy MJ, Adams EJ. Understanding health outcomes: Physical secondary conditions in people with spinal cord injury. Rehabil Psychol 2007;52:338.
24. Levi R, Hultling C, Seiger A. The Stockholm Spinal Cord Injury Study: 2. Associations between clinical patient characteristics and post-acute medical problems. Paraplegia 1995;33:585-94.
25. Burchiel KJ, Hsu FP. Pain and spasticity after spinal cord injury: mechanisms and treatment. Spine 2001;26:S146-60.
26. Adams MM, Hicks AL. Spasticity after spinal cord injury. Spinal Cord 2005;43:577.
27. Cao Y, Massaro JF, Krause JS, Chen Y, Devivo MJ. Suicide mortality after spinal cord injury in the United States: injury cohorts analysis. Arch Phys Med Rehabil 2014;95:230-5.
28. DeVivo MJ, Black K, Richards JS, Stover S. Suicide following spinal cord injury. Paraplegia 1991;29:620-7.
29. Frisbie JH, Kache A. Increasing survival and changing causes of death in myelopathy patients. J Am Paraplegia Soc 1983;6:51-6.
30. Geisler WO, Jousse A, Wynne-Jones M, Breithaupt D. Survival in traumatic spinal cord injury. Spinal Cord 1983;21:364-73.
31. Ghaisas S, Pyatak EA, Blanche E, Blanchard J, Clark F. Lifestyle changes and pressure ulcer prevention in adults with spinal cord injury in the Pressure Ulcer Prevention Study lifestyle intervention. Am J Occup Ther 2015;69:6901290020p1-10.
32. Gelis A, Dupeyron A, Legros P, Benaim C, Pelissier J, Fattal C. Pressure ulcer risk factors in persons with spinal cord injury part 2: the chronic stage. Spinal Cord 2009;47:651-61.
33. Scheel-Sailer A, Wyss A, Boldt C, Post M, Lay V. Prevalence, location, grade of pressure ulcers and
association with specific patient characteristics in adult spinal cord injury patients during the hospital stay: a prospective cohort study. Spinal Cord 2013;51:828-33.
34. Chen Y, DeVivo MJ, Jackson AB. Pressure ulcer prevalence in people with spinal cord injury: age-period-duration effects. Arch Phys Med Rehabil 2005;86:1208-13.
35. Smith BM, Guihan M, LaVela SL, Garber SL. Factors predicting pressure ulcers in veterans with spinal cord injuries. Am J Phys Med Rehabil 2008;87:750-7.
36. Budh CN, Lund I, Ertzgaard P, Holtz A, Hultling C, Levi R et al. Pain in a Swedish spinal cord injury population. Clin Rehabil 2003;17:685-90.
37. Störmer S, Gerner H, Grüninger W, Metzmacher K, Föllinger S, Wienke C et al. Chronic pain/dysaesthesiae in spinal cord injury patients: results of a multicentre study. Spinal Cord 1997;35:446-55.
38. Hajiaghababaei M, Javidan AN, Saberi H, Khoei EM, Khalifa DA, Koenig HG et al. Female sexual dysfunction in patients with spinal cord injury: a study from Iran. Spinal Cord 2014;52:646-9.
39. Khak M, Hassanijirdehi M, Afshari-Mirak S, Holakouie-Naieni K, Saadat S, Taheri T et al. Evaluation of Sexual Function and Its Contributing Factors in Men With Spinal Cord Injury Using a Self-Administered Questionnaire. Am J Mens Health 2016;10:24-31
Published
2019-01-16
How to Cite
1.
Ghajarzadeh M, Saberi H. Association Between Depression and Chronic Complications in Clients With Traumatic Spinal Cord Injury. Acta Med Iran. 56(11):704-709.
Section
Articles