Spinal cord injury: a search for determinants of depression two years after the event

A prospective longitudinal study employing repeated measures was used to isolate factors which might predispose a person to depression two years after sustaining spinal cord injury (SCI). Thirty-one subjects who suffered acute spinal injuries resulting in permanent loss of movement, and who had no head injuries or any pre-existing psychopathology, were at least 17 years of age, and who were able to speak English, participated in the study. Using the Beck Depression Inventory (BDI) as a measure of depression, a regression analysis demonstrated that the experience of pain two years post-injury and feeling out of control of one's life prior to hospital discharge were predictive of depression two years post-injury. No demographic variables or injury characteristics such as level of lesion or completeness of lesion were related to long-term depression. Pain management and rehabilitation techniques that enhance the individual's belief of control over their lives are therefore recommended as interventions that could act to reduce depression in the long term in persons with spinal cord injury.