Low depressive symptoms in acute spinal cord injury compared to other neurological disorders
The aim of the study was to reveal the incidence and time course of depressive symptoms following acute spinal cord injury (SCI) in relation to clinical outcomes for comparison to other neurological disorders with severe impairment. In patients with acute traumatic SCI (n = 130), combined follow up assessments of neurological and functional outcomes, pain and patient-rated affective factors (e.g. mood, anxiety) were prospectively (1, 3, 6, 12 months after injury) collected during rehabilitation and follow up in out-patient clinics. We related these to the severity of depressive symptoms (no, mild, moderate and severe) based on the Beck Depression Inventory (BDI) scores. The mean 65% of patients showed no depressive symptoms and 30% mild depressive symptoms, while less than 5% presented moderate to severe depressive symptoms. The group findings and symptoms in individual patients remained stable over 1 year though patients revealed significant clinical recovery. Although two-thirds of the patients experienced pain, BDI scores were not related to pain intensity. BDI mean scores were only slightly higher than in control populations, but rather low compared to patients with other neurological disorders (e.g. stroke and multiple sclerosis) that are also associated with severe functional impairment. The prevalence of depressive symptoms following acute SCI is rather low and remains stable within the first year after injury despite the severe neurological impairment and loss of independency. In comparison to other neurological disorders that also involve brain function SCI patients seem to be less challenged by depressive symptoms that constitute additional burdens to respond to the severe functional impairments.
KeywordsDepressive symptoms Spinal cord injury Beck Depression Inventory ASIA Neurological disorders
We would like to thank the EM-SCI study group, especially René Koller from Zurich and Dr. F. Röhrich of the Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Germany). The following centers participated in this study: K. Röhl, MD, Berufsgenossenschaftliche Kliniken Bergmannstrost, Halle (Germany); N. Weidner and R. Rupp, University Clinic of Heidelberg (Germany); R.D. Sambale, MD, Orthopädische Klinik Hessisch-Lichtenau (Germany); J. Harms, MD, SRH Klinikum Karlsbad-Langensteinbach (Germany); D. Maier, MD, Berufsgenossenschaftliche Klinik in Murnau (Germany), Y.-B. Kalke, MD, Rehabilitationskrankhaus Ulm (Germany) and, M. Schubert, MD, Balgrist University Hospital, Zurich (Switzerland). We are grateful to Boris Quednow, MD, Psychiatric University Hospital Zurich, for his helpful comments on the manuscript. We would also like to thank all the patients for their willingness to invest their time in this study. Supported by the International Foundation for Research in Paraplegia (IFP) and the International Spinal Research Trust (ISRT; Stage II of the Clinical Initiative: CLI006) and the Swiss National Science Foundation (SNF, PMPDP3-124282).
Conflict of interest
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