Depression, Pain Intensity, and Interference in Acute Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2014 · DOI: 10.1310/sci2001-32 · Published: January 1, 2014

Spinal Cord Injury Mental Health Pain Management

Simple Explanation

This study investigates the relationship between depression, pain intensity, and pain interference in individuals with acute spinal cord injury (SCI) during inpatient rehabilitation. Participants completed surveys measuring depression (PHQ-9), pain intensity, and pain interference (Brief Pain Inventory). The study found that pain interference, or how much pain disrupts daily life, has a much greater impact on depression than pain intensity alone.

Study Duration

Not specified

Participants

203 individuals undergoing acute inpatient rehabilitation for traumatic SCI

Evidence Level

Not specified

Key Findings

1
Pain interference accounted for 13% to 26% of the variance in depression, while pain intensity accounted for only 0.2% to 1.2%.
2
Pain intensity alone is insufficient for understanding the relationship of pain and depression in acute SCI.
3
The ways in which pain interferes with daily life appear to have a much greater bearing on depression than pain intensity alone in the acute setting.

Research Summary

The study examined the independent contributions of pain intensity and pain interference to depression, while accounting for injury and demographic characteristics, antidepressant treatment, and pre-injury binge drinking in a sample of persons with acute SCI. The results suggest that, for persons with acute SCI, pain intensity alone is not sufficient for understanding the relationship of pain and depression. The findings of this study suggest that pain interference and not just pain intensity alone has a strong relationship with depression during the acute phase of SCI rehabilitation.

Practical Implications

Treatment Approaches

Comprehensive treatment approaches that target pain intensity, pain interference, and depression, in combination and with multidisciplinary collaboration, may be the most effective.

Clinical Practice

An exclusive reliance on pain intensity creates an incomplete picture. It is important to address both pain and depression in the acute setting not as separate entities, but as linked by the impact of pain on important life domains.

Future Research

Longitudinal studies are needed to further understand the link between pain intensity, interference, and depression in SCI over time and to examine the efficacy and effectiveness of collaborative approaches to treatment.

Study Limitations

1
Cross-sectional study limits causal inferences.
2
Pain interference measurement in acute rehabilitation limits the variability of experience.
3
Sample size precluded examination of the indirect effect of pain intensity through pain interference.

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