Spinal cord injury increases risk for mental health disorders

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The research team examined insurance claims data for adults, both with traumatic spinal cord injury and those without the condition, enrolled in a health insurance plan for at least three consecutive years and their diagnosis of a mental health disorder. Image is in the public domain.

Summary: People who experience a spinal cord injury have an increased risk of developing a mental health disorder, a new study reports. Those with SCI had higher instances of anxiety, depression, and psychological multimorbidity than those who had not experienced a debilitating injury.

Source: University of Michigan

In a new study, published in Mayo Clinic Proceedings, researchers from Michigan Medicine find adults with spinal cord injury are at a higher risk of developing mental health disorders, including depression and anxiety, compared to adults without the condition.

The research team examined insurance claims data for adults, both with traumatic spinal cord injury and those without the condition, enrolled in a health insurance plan for at least three consecutive years and their diagnosis of a mental health disorder. In particular, they found adults with spinal cord injury had a higher incidence of anxiety disorders (19.3% vs 14.1%), depressive disorders (29.3% vs 9.3%), and psychological multimorbidity, or having more than two mental health conditions (37.4% vs 23.9%), as compared to adults without spinal cord injury.

“We also found that individuals with spinal cord injury had an increased risk of developing other chronic diseases, including cardiovascular and pulmonary diseases, diabetes, liver disease, cancer, arthritis, circulatory conditions and electrolyte disorders,” says Mark Peterson, Ph.D., M.S., FACSM, the Charles E. Lytle, Jr. Research Professor in physical medicine and rehabilitation at Michigan Medicine and the lead author of the study. “Which makes sense, as patients with spinal cord injuries have extreme sedentary behavior including prolonged bed rest after injury.”

Denise Tate, Ph.D., ABPP, FACRM, a professor of physical medicine and rehabilitation at Michigan Medicine and the senior author of the study, notes that much of the past research regarding spinal cord injury focuses on physical health outcomes. She says this study highlights the need for understanding this patient population’s mental health and clinical care needs, as they’re critical to overall quality of life and well-being in patients with spinal cord injury.

Peterson agrees, “Clinicians caring for adults with spinal cord injury need to be aware of the increased risk of developing mental health disorders in this patient population. This may be particularly important during these recent times of social distancing due to COVID-19, as these patients often already experience social isolation.”

About this neuroscience research article

Source:
University of Michigan
Media Contacts:
Kylie Urban – University of Michigan
Image Source:
The image is in the public domain.

Original Research: Closed access
“Psychological Morbidity and Chronic Disease Among Adults With Traumatic Spinal Cord Injuries”. by Mark D. Peterson, PhD, MS, Neil Kamdar, MA, Anthony Chiodo, MD, Denise G. Tate, PhD.
Mayo Clinic Proceedings doi:10.1016/j.mayocp.2019.11.029

Abstract

Psychological Morbidity and Chronic Disease Among Adults With Traumatic Spinal Cord Injuries

Objective
To compare the longitudinal incidence of psychological morbidities and multimorbidity and estimates of chronic diseases among adults with spinal cord injuries (SCIs) as compared with adults without SCIs.

Methods

Privately insured beneficiaries who had medical coverage at any time between January 1, 2001, and December 31, 2017 were included if they had an International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic code for a traumatic SCI (n=6,847).

Results
Adults with SCIs (n=6847) had a higher incidence of adjustment reaction (7.2% [n=493] vs 5.0% [n=42,862]), anxiety disorders (19.3% [n=1,322] vs 14.1% [n=120,872]), depressive disorders (29.3% [n=2,006] vs 9.3% [n=79,724]), alcohol dependence (2.4% [n=164] vs 1.0% [n=8,573]), drug dependence (2.3% [n=158] vs 0.8% [n=6,858]), psychogenic pain (1.0% [n=69] vs 0.2% [n=1,715]), dementia (6.5% [n=445] vs 1.5% [n=12,859]), insomnia (10.9% [n=746] vs 7.2% [n=61,722]), and psychological multimorbidity (37.4% [n=2,561] vs 23.9% [n=204,882]) as compared with adults without SCIs (n=857,245). The adjusted hazard ratios (HRs) of each psychological outcome were significantly higher for individuals with SCI and ranged from 1.18 (95% CI, 1.08-1.29) for anxiety disorders to 3.32 (95% CI, 1.93-5.71) for psychogenic pain. Adults with SCIs also had a significantly higher prevalence of all chronic diseases and chronic disease multimorbidity (51.1% vs 14.1%), except human immunodeficiency virus infection/AIDS. After propensity matching for age, education, race, sex, and chronic diseases (n=5884 matched pairs), there was still a significantly higher incidence of most psychological disorders and psychological multimorbidity among adults with SCIs.

Conclusion

Adults with traumatic SCIs experienced an increased incidence of psychological morbidities and multimorbidity as compared with adults without SCIs. Clinical efforts are needed to improve mental health screening and targeted interventions to reduce the risk for psychological disease onset in the traumatic SCI population.

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