Depression and Quality of Life in Spinal Cord Injury Patients Living in the Community After Hospital Discharge

Main Article Content

Cholavech Chavasiri
Nopchanok Sukprasert
Srinual Chavasiri
http://orcid.org/0000-0002-4439-4975

Abstract

Objective: To investigate quality of life (QoL) and the prevalence of depression, and to identify factors significantly associated with QoL and depression in spinal cord injury (SCI) patients living in the community after hospital discharge.
Methods: This prospective study included SCI patients that have a follow-up evaluation and care at the Siriraj Spinal Unit of the Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during April 2015 to February 2018. Presence and level of depression and QoL were assessed using Patient Health Questionnaire-9 (PHQ-9) and World Health Organization Quality of Life Brief-Thai (WHOQOL-BREFTHAI), respectively. Age, gender, education level, income, marital status, level of impairment, injury severity, cause of injury, and time since injury were collected and recorded.
Results: One hundred and twelve spinal injury patients (64.3% male) with a mean age of 44.3±15.3 years were enrolled. The prevalence of depression was 39.3%, and the mean overall QoL was a moderate 90.3±14.7. Multivariate analysis revealed marital status to be the only independent predictor of depression after hospital discharge (odds ratio [OR]: 2.99, 95% confidence interval [CI]: 1.19-7.51; p=0.020). Regarding QoL, multivariate analysis revealed educational level (OR: 16.18, 95% CI: 3.01-87.03; p=0.001), level of impairment (OR: 9.20, 95% CI: 1.84-46.13; p=0.007), and depression (OR: 50.39, 95% CI: 7.94-319.83; p<0.001) to be independent predictors of quality of life.
Conclusion: Depression was observed in 39.3% of SCI, and most study patients had moderate QoL. Marital status predicts depression; and, educational level, level of impairment, and presence of depression predict QoL.

Downloads

Download data is not yet available.

Article Details

How to Cite
Chavasiri, C., Sukprasert, N., & Chavasiri, S. (2019). Depression and Quality of Life in Spinal Cord Injury Patients Living in the Community After Hospital Discharge. Siriraj Medical Journal, 72(1), 59-66. https://doi.org/10.33192/Smj.2020.08
Section
Original Article

References

1. Wong AWK, Heinemann AW, Wilson CS, Neumann H, Fann JR, Tate DG, et al. Predictors of participation enfranchisement after spinal cord injury: the mediating role of depression and moderating role of demographic and injury characteristics. Arch Phys Med Rehabil 2014;95:1106-13.
2. Fullerton DT, Harvey RF, Klein MH, Howell T. Psychiatric disorders in patients with spinal cord injuries. Arch Gen Psychiatry 1981;38:1369-71.
3. Craig A, Tran Y, Middleton J. Psychological morbidity and spinal cord injury: a systematic review. Spinal Cord 2009;47:108-14.
4. Hoffman JM, Bombardier CH, Graves DE, Kalpakjian CZ, Krause JS. A longitudinal study of depression from 1 to 5 years after spinal cord injury. Arch Phys Med Rehabil 2011;92:411-8.
5. Krause JS, Kemp B, Coker J. Depression after spinal cord injury: relation to gender, ethnicity, aging, and socioeconomic indicators. Arch Phys Med Rehabil 2000;81(8):1099-109.
6. Bombardier CH, Fann JR, Tate DG, Richards JS, Wilson CS, Warren AM, et al. An exploration of modifiable risk factors for depression after spinal cord injury: which factors should we target? Arch Phys Med Rehabil 2012;93:775-81.
7. National Spinal Cord Injury Model Systems. Spinal cord injury facts and figures at a glance. [Internet]. 23 Jan 2015. Available from: www.nscisc.uab.edu/PublicDocuments/fact_figures_docs/Facts%202013.
8. Elliott TR, Frank RG. Depression following spinal cord injury. Arch Phys Med Rehabil 1996;77:816-23.
9. Kennedy P, Rogers BA. Anxiety and depression after spinal cord injury: a longitudinal analysis. Arch Phys Med Rehabil 2000;81:932-7.
10. Dijkers MP. Quality of life of individuals with spinal cord injury: a review of conceptualization, measurement, and research findings. J Rehabil Res Dev 2005;42:87-110.
11. Post M, Noreau L. Quality of life after spinal cord injury. J Neurol Phys Ther. 2005;29:139-46.
12. Holicky R, Charlifue S. Ageing with spinal cord injury: the impact of spousal support. Disabil Rehabil 1999;21:250-7.
13. Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW, et al. Depression following traumatic spinal cord injury. Neuroepidemiology 2005;25:55-61.
14. Tate DG, Kalpakjian CZ, Forchheimer MB. Quality of life issues in individuals with spinal cord injury. Arch Phys Med Rehabil 2002;83:S18-25.
15. Lotrakul M, Sumrithe S, Saipanish R. Reliability and validity of the Thai version of the PHQ-9. BMC Psychiatry 2008;8:46.
16. Mahatnirankul S, Tantipiwatanaskul W, Pumpaisalchai W, Wongsuwan K, Promanajirankul R. Comparison of the WHOQOL-100 and the WHOQOL-BREF (26 items). J Ment Health Thai 1997;5:4-15.
17. Pongboriboon P, Tongprasert S, Kovindha A. Quality of life in persons with spinal cord injury: a comparative study between those with indwelling catheterization and intermittent catheterization. J Thai Rehabil Med 2011;21:13-20.
18. Krause JS, Saunders LL, Reed KS, Coker J, Zhai Y, Johnson E. Comparison of the Patient Health Questionnaire and the Older Adult Health and Mood Questionnaire for self-reported depressive symptoms after spinal cord injury. Rehabil Psychol 2009;54:440-8.
19. Bombardier CH, Richards JS, Krause JS, Tulsky D, Tate DG. Symptoms of major depression in people with spinal cord injury: implications for screening. Arch Phys Med Rehabil 2004;85:1749-56.
20. Hill MR, Noonan VK, Sakakibara BM, Miller WC, SCIRE Research Team. Quality of life instruments and definitions in individuals with spinal cord injury: a systematic review. Spinal Cord 2010;48:438-50.
21. Choochart N, Vichiansiri R, Arayawichanon P, Manimmanakorn N. Quality of life of traumatic spinal cord injured patients in North-East region of Thailand. J Thai Rehabil Med 2015;25:15-21.
22. Wannapakhe J, Amatachaya S, Siritaratiwat W, Arrayawichanon P, Wattanapan P. Physical abilities, quality of life, incidences of complications and falls in patients with chronic spinal cord injury after discharge. J Med Tech Phy Ther 2010;22:188-9.
23. Trevittaya P, Wattanavittawat P. Quality of life and perceived health status among people with spinal cord injury. Bull Chiang Mai Assoc Med Sci 2016;49:185-96.
24. Scivoletto G, Petrelli A, Di Lucente L, Castellano V. Psychological investigation of spinal cord injury patients. Spinal Cord 1997;35:516-20.
25. Tzanos IA, Mavrogenis A, Gioti K, Papagelopoulos P, Panagiotopoulos E. Depressive mood in individuals with spinal cord injury (SCI) living in Greece. Spinal Cord 2018;56:883-9.
26. Craig AR, Hancock KM, Dickson HG. Spinal cord injury: a search for determinants of depression two years after the event. Br J Clin Psychol 1994;33:221-30.
27. Kalpakjian CZ, Albright KJ. An examination of depression through the lens of spinal cord injury. Comparative prevalence rates and severity in women and men. Womens Health Issues 2006;16:380-8.
28. Orenczuk S, Mehta S, Slivinski J, Teasell RW. Depression following spinal cord injury. In: Eng JJ, Teasell RW, Miller WC, Wolfe DL, Townson AF, Hsieh JTC, Connolly SJ, Noonan VK, Loh E, McIntyre A, editors. Spinal Cord Injury Rehabilitation Evidence. Version 5.0. 2014. p. 1-33.
29. Dajpratham P, Kongkasuwan R. Quality of life among the traumatic spinal cord injured patients. J Med Assoc Thai 2011;94:1252-9.
30. Salilpramote B. Quality of life of patients with spinal cord lesion. 12th Reg Med J 2016;27:112-8.
31. Jain NB, Sullivan M, Kazis LE, Tun CG, Garshick E. Factors associated with health-related quality of life in chronic spinal cord injury. Am J Phys Med Rehabil 2007;86:387-96.
32. Tate D, Forchheimer M, Maynard F, Dijkers M. Predicting depression and psychological distress in persons with spinal cord injury based on indicators of handicap. Am J Phys Med Rehabil 1994;73:175-83.