Article

OBJECTIVE: To determine the number and type of longitudinal depression
trajectories during the first year after spinal cord injury (SCI) and to identify
baseline predictors of these trajectories. DESIGN:
Cohort study. SETTING:
Rehabilitation and postacute community settings. PARTICIPANTS:
Of 168 consecutive
admissions to inpatient rehabilitation for acute SCI, 141 (115 men, 26 women)
patients were enrolled in a randomized controlled trial telephone follow-up
intervention, which showed no outcome differences, and completed assessments on
at least 2 of the 4 follow-up occasions (3, 6, 9, and 12 months after SCI).
Participants were on average 41 years old, most were non-Hispanic (96%) and white
(86%), and 61.7% had tetraplegia. INTERVENTIONS: Data were drawn from the
ineffective randomized controlled trial. MAIN OUTCOME MEASURE: Patient Health
Questionnaire-9 (PHQ-9). RESULTS: Unconditional linear latent class growth
analysis models of PHQ-9 total scores revealed an optimal 3-class solution:
stable low depression (63.8%), mild to moderate depression (29.1%), and
persistent moderate to severe depression (7.1%). Preinjury mental health history
and baseline pain, quality of life, and grief predicted class membership.
CONCLUSIONS: The modal response to SCI was stable low depression, whereas
persistent moderate to severe depression primarily represented a continuation or
relapse of preinjury depression. This line of research has the potential to
improve identification of subgroups destined for poor outcomes and to inform
early intervention studies.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS