Psychological morbidity and spinal cord injury: a systematic review

• Published in: Spinal cord Vol. 47; no. 2; pp. 108 - 114
• Main Authors: Craig, A, Tran, Y, Middleton, J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.02.2009; Nature Publishing Group
• Subjects: Anatomy; Behavioral Symptoms - epidemiology; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cerebrospinal fluid. Meninges. Spinal cord; Databases, Factual - statistics & numerical data; Human Physiology; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Medical sciences; Morbidity; Nervous system (semeiology, syndromes); Neurochemistry; Neurology; Neuropsychology; Neurosciences; original-article; Spinal Cord Injuries - epidemiology; Spinal Cord Injuries - psychology; Traumas. Diseases due to physical agents; spinal cord injury; anxiety; post-traumatic stress disorder; depression; quality of life; psychological morbidity; Mood disorder; Affect affectivity; Nervous system diseases; Vertebral canal; Anxiety disorder; Depression; Posttraumatic stress disorder; Stress; Quality of life; Psychological distress; Spinal cord trauma; Central nervous system disease; Anxiety; Spinal cord disease
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sc.2008.115

Study Design: A systematic review of the literature concerning the nature of the psychological morbidity in people with spinal cord injury (SCI). Objectives: SCI is believed to place the individual at a high risk of psychological morbidity. The objective of this paper was to examine systematically the prevalence of negative psychological states in people with SCI, as well as to explore mediating and contextual factors. Methods: Search engines such as Medline and PsycInfo were systematically searched using specific key words, such as SCI, depression, anxiety and so on. Only studies that fulfilled certain criteria such as the use of valid measures in assessing psychological morbidity were used in the review process. Results: The systematic review revealed that clarification is still needed concerning the psychological consequences of people with SCI. However, findings suggest that approximately 30% of people with SCI are at risk of having a depressive disorder although in rehabilitation, and approximately 27% are at risk of having raised depressive symptoms when living in the community. The review also established that people with SCI have higher comparative risks of anxiety disorder, elevated levels of anxiety, feelings of helplessness and poor quality of life (QOL). Conclusion: People with SCI have an increased risk of suffering debilitating levels of psychological morbidity. Future research needs to clarify the extent and nature of psychological morbidity following SCI by conducting prospective and comprehensive research in large heterogeneous samples of people with SCI during the rehabilitation phase and following reintegration into the community.