Article

OBJECTIVES: To use meta-analysis to synthesize point prevalence estimates of
depressive disorder diagnoses for persons who have sustained a spinal cord injury
(SCI). DATA SOURCES: We searched PsycINFO, PubMed, the Cumulative Index to
Nursing and Allied Health Literature (CINAHL), and Dissertation Abstracts
International (DAI) for studies examining depression after SCI through 2013. We
also conducted a manual search of the reference sections of included studies.
STUDY SELECTION: Included studies contained persons with SCI; used a diagnostic
measure of depression (ie, an unstructured, semi-structured, or structured
clinical interview, and/or a clinician diagnosis); and provided a diagnosis of
major or minor depressive episodes for the subjects in the study. Diagnostic
criteria were based on the Diagnostic and Statistical Manual of Mental Disorders,
Fourth Edition, or the Diagnostic and Statistical Manual of Mental
Disorders-Third Edition (including Research Diagnostic Criteria) criteria. DATA EXTRACTION: The 2 authors of this study screened the titles and abstracts of 1053
unique studies for inclusion in this meta-analysis. Nineteen studies, containing
35,676 subjects and 21 effect size estimates, were included.
DATA SYNTHESIS: The
mean prevalence estimate of depression diagnosis after SCI was 22.2%, with a
lower-bound estimate of 18.7% and an upper bound estimate of 26.3%. Random
effects and mixed effects models were used in this work. A small number of study
moderators were explored, including sample sex composition, Diagnostic and
Statistical Manual of Mental Disorders version used, data collection method
(primary vs secondary), sample traumatic etiology composition, sample injury
level and completeness composition, and sample diagnostic composition. Data
collection method, Diagnostic and Statistical Manual of Mental Disorders version,
and diagnostic composition significantly predicted variation in observed effect
size estimates, with primary data collection studies having lower estimates
compared with secondary data analysis studies, studies using Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria
having higher estimates compared with studies using Diagnostic and Statistical
Manual of Mental Disorders, Third Edition, criteria, and samples comprising
individuals diagnosed only with major depression having lower prevalence
estimates. CONCLUSIONS: The existing data on depression after SCI indicate that
the prevalence of depression after SCI is substantially greater than that in the
general medical population. These results underscore the importance of continued
research on measuring depression in persons with SCI and on treatments for
depression after SCI.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS