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Anxiety and Depression in Pediatric-Onset Traumatic Spinal Cord Injury: A Systematic Review
Mohammad Mofatteh1, Mohammad Sadegh Mashayekhi2, Saman Arfaie3
1School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK; Neuro International Collaboration (NIC), London, UK.
Insights
Pediatric traumatic spinal cord injury (TSCI) is linked to significant anxiety and depression. Identifying and supporting at-risk youth is crucial for improved mental health outcomes.
Area of Science:
- Neurology
- Psychiatry
- Rehabilitation Medicine
Background:
- Traumatic spinal cord injury (TSCI) in children and adolescents presents unique challenges.
- Long-term mental health, specifically anxiety and depression, is a significant concern for pediatric TSCI survivors.
- Understanding the prevalence and risk factors for these conditions is vital for effective care.
Approach:
- A systematic review was conducted following PRISMA guidelines.
- Searches were performed across PubMed, Scopus, and Web of Science databases up to December 20, 2022.
- Eligibility criteria were applied to select relevant studies for analysis.
Key Points:
- 18 studies involving 4234 individuals with pediatric-onset TSCI were included.
- Motor vehicle accidents were the most common cause (36.5%).
- Pain, poor sleep, reduced independence, and incomplete injury were associated with higher rates of anxiety and depression.
Conclusions:
- Biopsychosocial factors significantly contribute to anxiety and depression in pediatric TSCI.
- Early identification and targeted interventions are necessary for at-risk individuals.
- Further large-scale, longitudinal studies are recommended to confirm these findings.
Background:
Traumatic spinal cord injury (TSCI) is a debilitating neurological condition with significant long-term consequences on the mental health and well-being of affected individuals. We aimed to investigate anxiety and depression in individuals with pediatric-onset TSCI.
Methods:
PubMed, Scopus, and Web of Science databases were searched from inception to December 20th, 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and studies were included according to the eligibility criteria.
Results:
A total of 1013 articles were screened, and 18 studies with 4234 individuals were included in the final review. Of these, 1613 individuals (38.1%) had paraplegia, whereas 1658 (39.2%) had tetraplegia. A total of 1831 participants (43.2%) had complete TSCI, whereas 1024 (24.2%) had incomplete TSCI. The most common etiology of TSCI with 1545 people (36.5%) was motor vehicle accidents. The youngest mean age at the time of injury was 5.92 ± 4.92 years, whereas the oldest was 14.6 ± 2.8 years. Patient Health Questionnaire-9 was the most common psychological assessment used in 9 studies (50.0%). Various risk factors, including pain in 4 studies (22.2%), reduced sleep quality, reduced functional independence, illicit drug use, incomplete injury, hospitalization, reduced quality of life, and duration of injury in 2 (11.1%) studies, each, were associated with elevated anxiety and depression.
Conclusions:
Different biopsychosocial risk factors contribute to elevated rates of anxiety and depression among individuals with pediatric-onset TSCI. Individuals at risk of developing anxiety and depression should be identified, and targeted support should be provided. Future large-scale studies with long-term follow-up are required to validate and extend these findings.
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