Prospective Study of the Occurrence of Psychological Disorders and Comorbidities After Spinal Cord Injury
Prospective Study of the Occurrence of Psychological Disorders and Comorbidities After Spinal Cord Injury
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DOI：
10.1016/j.apmr.2015.02.027
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发表时间：
2015-08-01
影响因子：
4.3
通讯作者：
Middleton, James
中科院分区：
文献类型：
--
作者：
Craig, Ashley;Perry, Kathryn Nicholson;Middleton, James
目的：对脊髓损伤（SCI）后心理障碍和合并症的发生进行前瞻性研究，确定精神药物的使用，并建立过渡到社区后心理障碍的预测因素。设计：多指标纵向设计。设置：评估发生在SCI单位和社区。参与者的：成年人SCI（N=88）在32个月的时间内进入3 SCI units.Interventions：参与者完成了急性SCI住院康复。纵向评估发生了6个月postdischarge.Main Outcome Measures：措施选择了一个理论和临床基础，有助于恢复后SCI。迷你国际，神经精神访谈，一个结构化的诊断精神病学访谈，进行了确定心理障碍的存在。医疗措施包括继发性疾病或并发症的严重程度。心理措施，包括措施的焦虑和抑郁情绪，弹性，疼痛catastrophization，自我效能，和cognitive capability.Results：17%至25%的心理障碍率大大高于在澳大利亚社会发现的利率。心理障碍合并症的发生率也很高。焦虑在那些有心理障碍的人中显着升高。超过36%的样本使用了精神药物，其中大多数是抗抑郁药。预测心理障碍的因素包括多年的教育，发病前的精神/心理治疗，认知障碍，继发性并发症，弹性，和anxiety.Conclusions：SCI可以有一个实质性的负面影响，心理健康，不改变6个月postdischarge。研究结果表明，大量的少数经验增加受伤后，过渡到社区后的心理困扰。应该投入更多的资源来改善成年SCI患者的心理健康。(C)2015年美国康复医学大会
Objective: To conduct a prospective study of the occurrence of psychological disorders and comorbidities after spinal cord injury (SCI), determine psychotropic medication usage, and establish predictors of psychological disorders after transition to the community.Design: Longitudinal design with multiple measures.Setting: Assessment occurred in SCI units and the community.Participant's: Adults with SCI (N=88) admitted over a period of 32 months into 3 SCI units.Interventions: Participants completed inpatient rehabilitation for an acute SCI. Longitudinal assessment occurred up to 6 months postdischarge.Main Outcome Measures: Measures were chosen that had a theoretical and clinical foundation for contributing to recovery after SCI. The Mini International, Neuropsychiatric Interview, a structured diagnostic psychiatric interview, was conducted to determine the presence of psychological disorders. Medical measures included severity of secondary conditions or complications. Psychological measures included measures of anxiety and depressive mood, resilience, pain catastrophization, self-efficacy, and cognitive capacity.Results: Rates of psychological disorders of 17% to 25% were substantially higher than rates found in the Australian community. The occurrence of psychological disorder comorbidities was also very high. Anxiety was significantly elevated in those with a psychological disorder. Psychotropic medications were prescribed to more than 36% of the sample, with most being antidepressants. Factors predictive of psychological disorders included years of education, premorbid psychiatric/psychological treatment, cognitive impairment, secondary complications, resilience, and anxiety.Conclusions: SCI can have a substantial negative impact on mental health that does not change up to 6 months postdischarge. Findings suggest a substantial minority experience increased psychosocial distress after the injury and after transitioning into the community. Additional resources should be invested in improving the mental health of adults with SCI. (C) 2015 by the American Congress of Rehabilitation Medicine