Article

OBJECTIVE: To investigate mental health problems in adults with pediatric-onset
spinal cord injury (SCI) and explore how these problems relate to the risk of
negative outcomes over time. METHOD: The study included 466 adults who sustained
an SCI prior to age 19 years and had been injured for at least 1 year.
Participants were interviewed on an approximately annual basis using a
study-specific questionnaire and standardized measures of depression, anxiety,
substance use, and community involvement. Generalized estimating equations were
used to assess the risk of negative outcomes across time as a function of
depression, anxiety, and substance misuse. RESULTS: Of the participants who
reported on each domain of mental health, 26% reported misuse of alcohol or drugs
(122/466), 21% reported problems with depression (78/360), and 29% reported
problems with anxiety (49/168). Depression was associated with increased odds of
pressure ulcers, urinary tract infections, hospitalizations, pain, and smoking
and lower levels of economic independence and mobility. Anxiety was associated
with increased odds of hospitalization, pain, and smoking. Substance misuse
predicted an increased risk of pressure ulcers, pain, and smoking and decreased
odds of occupational involvement. When examining the effect of mental health with
time, results showed that depression accelerated the risk of urinary tract
infections, respiratory complications, and hospitalizations and anxiety and
depression accelerated risk for lower occupational independence.
CONCLUSIONS: The
added burden that mental health difficulties pose for medical and psychosocial
outcomes highlight the importance of monitoring and treating mental health
symptoms in pediatric-onset SCI.

Langue : ANGLAIS