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.
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Original Article|
January 28 2014
Mental Health and Risk of Secondary Medical Complications in Adults With Pediatric-Onset Spinal Cord Injury
Alicia January;
Alicia January
1
Shriners Hospitals for Children–Chicago, Chicago, Illinois
2
Marquette University, Milwaukee, Wisconsin
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Kathy Zebracki;
Kathy Zebracki
1
Shriners Hospitals for Children–Chicago, Chicago, Illinois
3
Loyola University Chicago, Chicago, Illinois
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Kathleen Chlan;
Kathleen Chlan
1
Shriners Hospitals for Children–Chicago, Chicago, Illinois
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Lawrence Vogel
Lawrence Vogel
1
Shriners Hospitals for Children–Chicago, Chicago, Illinois
4
Rush Medical College, Chicago, Illinois
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Top Spinal Cord Inj Rehabil (2014) 20 (1): 1–12.
Citation
Alicia January, Kathy Zebracki, Kathleen Chlan, Lawrence Vogel; Mental Health and Risk of Secondary Medical Complications in Adults With Pediatric-Onset Spinal Cord Injury. Top Spinal Cord Inj Rehabil 1 January 2014; 20 (1): 1–12. doi: https://doi.org/10.1310/sci2001-1
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