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Prevalence of Depression After Spinal Cord Injury: A Meta-Analysis
Abstract
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.
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“People with SCI may experience many potential secondary physical and psychological consequences, including an increased risk of depression and anxiety (experienced in around 22.2% of the population [2]) and reduced quality of life (QoL [3]).”
From Mindfulness for pain, depression, anxiety, and quality of life in people with spinal cord injury: A systematic review (2020) · cites this paper as [2]
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Lee, W., Jeong, S., Lee, B.-S., Lim, J.-C., & Kim, O. (2023) · Scientific Reports · doi:10.1038/s41598-023-50252-8 · Cited by 15
Lim, C. A.-R., Nightingale, T. E., Elliott, S., & Krassioukov, A. V. (2019) · Spinal Cord · doi:10.1038/s41393-019-0404-z · Cited by 16
Depression in disabling medical conditions – current perspectives
Senra, H., & McPherson, S. (2021) · International Review of Psychiatry · doi:10.1080/09540261.2021.1887823 · Cited by 14
Hearn, J. H., Finlay, K. A., & Sheffield, D. (2021) · British Journal of Health Psychology · doi:10.1111/bjhp.12462 · Cited by 15
Bridging the gap: a translational perspective in spinal cord injury
Hassan, O. I., Takamiya, S., Asgarihafshejani, A., & Fehlings, M. G. (2024) · Experimental Biology and Medicine · doi:10.3389/ebm.2024.10266 · Cited by 16
Metadata
- Authors
- Williams, R., & Murray, A.
- Affiliations
- American Institutes for Research (US)
- University of Memphis (US)
- ORCID
- Williams, Ryan
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 96
- Issue
- 1
- Pages
- 133-140
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W2122275193
- Cited by
- 320
- References
- 41
- Citations by year
- 2026: 32 · 2025: 36 · 2024: 34 · 2023: 33 · 2022: 49 · 2021: 19 · 2020: 24 · 2019: 33 · 2018: 20 · 2017: 17 · 2016: 11 · 2015: 11
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Spinal Cord Injury Research
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Keywords
- depression, spinal cord injury, prevalence, depressive disorders, major depressive episode, psychiatric comorbidity, DSM-IV diagnostic criteria, DSM-III-R criteria, traumatic spinal cord injury
- MeSH terms
- Depressive Disorder, Humans, Spinal Cord Injuries, Prevalence
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