Depression Trajectories During the First Year After Spinal Cord Injury.
Depression Trajectories During the First Year After Spinal Cord Injury.
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脊髓损伤后第一年的抑郁轨迹。
DOI：
10.1016/j.apmr.2015.10.083
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发表时间：
2016-02
影响因子：
4.3
通讯作者：
Hoffman JM
中科院分区：
文献类型：
--
作者：
Bombardier CH;Adams LM;Fann JR;Hoffman JM
确定脊髓损伤（SCI）后第一年内纵向抑郁轨迹的数量和类型，并确定这些轨迹的基线预测因子。队列研究康复和急性期后社区环境。在168例因急性SCI住院康复的连续住院患者中，141例（115例男性和26例女性）患者参加了随机对照试验（RCT）电话随访干预，结果无差异，并在4次随访中的至少2次（SCI后3、6、9和12个月）完成了评估。参与者平均41岁，大多数是非西班牙裔（96%）和白色（86%），61.7%有四肢瘫痪。数据来自无效的随机对照试验。患者健康问卷-9（PHQ-9）。PHQ-9总分的无条件线性潜在类别增长分析模型显示了最佳的3类解决方案：稳定的低抑郁（63.8%），轻度至中度抑郁（29.1%），持续的中度至重度抑郁（7.1%）。伤前心理健康史和基线疼痛，生活质量和悲伤预测类成员。对SCI的模态反应是稳定的轻度抑郁，而持续的中度至重度抑郁主要代表伤前抑郁的持续或复发。这一系列的研究有可能改善亚组的识别注定为不良结果，并告知早期干预研究。
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. Cohort study Rehabilitation and postacute community settings. Of 168 consecutive admissions to inpatient rehabilitation for acute SCI, 141 (115 males and 26 females) patients were enrolled in a randomized controlled trial (RCT) 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. Data were drawn from the ineffective randomized controlled trial. Patient Health Questionnaire-9 (PHQ-9). 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. 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.