Psychosocial correlates of depression following spinal injury: A systematic review

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772314Y.0000000295 · Published: January 1, 2015

Simple Explanation

Depression is a common issue after spinal cord injury (SCI). Untreated, it can become chronic and impact health-related quality of life. Psychosocial stressors account for a significant amount of the variance in subjective wellbeing during the acute rehabilitation period and following discharge to the community. This review provides a reference point for comparing the relative importance of different psychosocial factors for the SCI population.

Study Duration

Not specified

Participants

3172 adults with spinal cord injury

Evidence Level

Systematic Review

Key Findings

1
Individual personal variables including affective feelings, and thoughts and beliefs specific to SCI demonstrated the strongest relationship with depression self-ratings.
2
Life satisfaction, disability acceptance, environmental supports and community participation had a medium to strong association, helping to reduce vulnerability to depression.
3
Longitudinal studies revealed that symptoms of depression continued to impact on psychosocial outcome up to 10 years post-injury.

Research Summary

This systematic review evaluated the observational data for 3,172 adults with an acquired SCI to identify the strongest psychosocial correlates of depression post injury. The present findings support recent literature positing that psychological difficulties, such as anxiety, may reinforce depressive thoughts and beliefs for a subset of individuals with a newly acquired injury. This systematic review highlights the significant association between depression symptomatology post-SCI and impairments across ICF domains.

Practical Implications

Early Intervention

Early assessment and management of psychosocial risk factors can limit the impact of SCI-related depression.

Skills Training

Coping Effectiveness Training and mindfulness-based approaches may be beneficial.

Social Support

Stable, reassuring social networks are important in the SCI rehabilitation process.

Study Limitations

1
The data search may have failed to identify all relevant studies.
2
Few effect size r estimates were based on multiple studies, which are considered to be far more reliable than estimates based on single studies.
3
The review relied primarily on cross-sectional and bivariate data, limiting any causal interpretations.

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