Clinical and demographic predictors of symptoms of depression and anxiety in patients with spinal cord injury

Spinal Cord. 2022 Dec;60(12):1123-1129. doi: 10.1038/s41393-022-00831-9. Epub 2022 Jul 15.

Abstract

Spinal Cord Injury (SCI) is a condition whose consequences can impact the physical, emotional, and social aspects of patient's life, including Depression and Anxiety disorders.

Study design: Using a cross-sectional design, sociodemographic and clinical data were extracted from 556 SCI patients at the time of initial assessment, prior to intensive rehabilitation treatment at the local rehabilitation institute.

Objectives: Identify the predictive and multivariate relationship between different sociodemographic and clinical variables of Depression and Anxiety symptoms in SCI patients.

Setting: Lucy Montoro Rehabilitation Institute (LMRI), University of Sao Paulo, Sao Paulo, Brazil.

Methods: We performed independent univariate and multivariate regression models using the Hospital Anxiety and Depression Scale (HADS) as dependent variable.

Results: Symptoms of depression and anxiety present in SCI patients negatively correlate with the level of independence for locomotion, personal hygiene, bowel control, social interaction measured by the Functional Independence Scale (FIM), type of medication in use and the Language subtest of the MoCA Scale. Unlike previous studies, we did not find a relationship with the use of alcohol and illicit drugs, injury levels, etiological diagnosis or duration of injury. For the anxiety models, the main predictor was Depression symptoms, with SCI-related aspects not being significant. It was found that characteristics of the FIM Scale and cognitive aspects of the MoCA Scale were the main predictors of symptoms of Depression. Characteristics of the injury and motor deficit were not statistically significant.

Conclusions: These findings can potentially be used to guide clinical practices to identify patients at higher risk of experiencing symptoms of Depression and Anxiety.

MeSH terms

  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety / etiology
  • Anxiety Disorders
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Demography
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / etiology
  • Humans
  • Spinal Cord Injuries* / complications
  • Spinal Cord Injuries* / epidemiology