Background: Little is known about depression and anxiety in adolescents with spinal cord injury (SCI). Objective: To examine how depression, anxiety, suicidal ideation, and usage of treatment differ by age and sex among adolescents with SCI. Method: Youth 12 to 18 years old who had acquired SCI at least 1 year prior were recruited from 3 specialty hospitals. They completed the Children’s Depression Inventory (ages 12-17 years) or Beck Depression Inventory-II (18 years), and Revised Children’s Manifest Anxiety Scale (12-18 years). Analyses assessed differences between younger and older adolescents and between males and females. Results: The 236 participants were an average age of 15.58 years (SD 1.98), 58% were male, and 60% Caucasian. Average age at injury was 10.57 years (SD 5.50), and 62% had paraplegia. For depression, 5.5% of adolescents ages 12 to 17 years exceeded the clinical cutoff and 12.7% of 18-year-old adolescents fell into a range of moderate or severe depression. For anxiety, 10.6% of adolescents ages 12 to 18 years exceeded the clinical cutoff. Univariate results revealed that older adolescents were more depressed than younger adolescents, and girls were more anxious than boys. An interaction between sex and age emerged, in that older adolescent girls were significantly more anxious than other youth. Older adolescents were also more likely to be taking medications for emotional, psychological, or behavioral reasons. Reports of suicidal ideation did not differ by adolescent age or sex. Conclusion: For these adolescents, depression differed with age, and anxiety differed based on age and sex. Implications for intervention include early identification and treatment for struggling adolescents.
US Census Bureau. American community survey 2005-2009. 2011. http://www.census.gov/acs/www. Accessed November 2012. http://www.census.gov/acs/www
Hoagwood K, Jensen PS, Petti T, Burns BJ. Outcomes of mental health care for children and adolescents: A comprehensive conceptual model. J Am Acad Child Psychiatry. 1996;35:1055–1063.
,
Outcomes of mental health care for children and adolescents: A comprehensive conceptual model
, J Am Acad Child Psychiatry.
, vol. 35
(pg. 1055
-1063
) World Health Organization. Caring for Children and Adolescents with Mental Disorders. Geneva: Author; 2003.
,
World Health Organization
, Caring for Children and Adolescents with Mental Disorders.
Lewinsohn P. Depression in adolescents. In: Gotlib, IH, Hammen, CL, ed. Handbook of Depression. New York: Guilford Press; 2003:541-553.
,
Depression in adolescents. In
, Handbook of Depression.
Gilied S, Pine DS. Consequences and correlates of adolescent depression. Arch Pediatr Adolesc Med. 2002;156:1009-1014.
,
Consequences and correlates of adolescent depression
, Arch Pediatr Adolesc Med.
, vol. 156
Centers for Disease Control and Prevention. Youth risk behavior surveillance system. 2009. www.cdc.gov/yrbs. www.cdc.gov/yrbs.
Beidel DC, Alfano CA. Child Anxiety Disorders. New York: Routledge; 2011.
,
Child Anxiety Disorders.
Sakolsky D, Birmaher B. Pediatric anxiety disorders: management in primary care. Curr Opin Pediatr. 2008;20(5):538-543.
,
Pediatric anxiety disorders: management in primary care.
, Curr Opin Pediatr.
, vol. 20
Kessler RC, Berglund P, Demier O, Jin R, Walters EE. Lifetime prevalence and age-onset of distributions of DSM IV disorders in the national comorbity survey replication. J Pers Disord. 2005;62:593-602.
,
Lifetime prevalence and age-onset of distributions of DSM IV disorders in the national comorbity survey replication
, J Pers Disord.
, vol. 62
Weissman MM, Wolk S, Goldstein RB, et al. Depressed adolescents grown up. JAMA. 1999;281(18):1701–1713.
,
Depressed adolescents grown up
, JAMA.
, vol. 281
(pg. 1701
-1713
) Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. J Pers Disord. 2003;60:837-844.
,
Prevalence and development of psychiatric disorders in childhood and adolescence
, J Pers Disord.
, vol. 60
Pine DS, Cohen P, Gurley D, Brook, J, Ma YJ. The risk for early adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. J Pers Disord. 1998;55:56-64.
,
The risk for early adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders
, J Pers Disord.
, vol. 55
Arango-Lasprilla JC, Ketchem JM, Starkweather A, Nicholis E, Wilk AR. Factors predicting depression among persons with spinal cord injury 1 to 5 years post injury. NeuroRehabilitation. 2011;29(1):9-21.
,
Factors predicting depression among persons with spinal cord injury 1 to 5 years post injury
, NeuroRehabilitation.
, vol. 29
Krause JS, Kemp B, Coker J. Depression after spinal cord injury: Relation to gender, ethnicity, aging, and socioeconomic indicators. Arch Phys Med Rehabil. 2000;81:1099-1109.
,
Depression after spinal cord injury: Relation to gender, ethnicity, aging, and socioeconomic indicators
, Arch Phys Med Rehabil.
, vol. 81
Frank RD, Chaney JM, Cleay DL, Shutty MS, et al. Dysphoria: A major syndrome factor in persons with disability or chronic illness. Psychiatry Res. 1992;43:231-241.
,
Dysphoria: A major syndrome factor in persons with disability or chronic illness
, Psychiatry Res.
, vol. 43
Fuhrer MJ, Rintala DH, Hart KA, et al. Depressive symptomatology in persons with SCI who reside in the community. Arch Phys Med Rehabil. 1993;74:255-260.
,
Depressive symptomatology in persons with SCI who reside in the community
, Arch Phys Med Rehabil.
, vol. 74
Hoffman JM, Bombardier CH, Graves DE, Kalpakjian CZ, Krause JS. A longitudinal study of depression from 1 to 5 years after spinal cord injury. Arch Phys Med Rehabil. 2011;92(3):411-418.
,
A longitudinal study of depression from 1 to 5 years after spinal cord injury
, Arch Phys Med Rehabil.
, vol. 92
North T. The psychological effects of spinal cord injury: A review. Spinal Cord. 1999;37:671-679.
,
The psychological effects of spinal cord injury: A review
, Spinal Cord.
, vol. 37
Anderson CJ, Vogel LC, Chlan KM, Betz RR, McDonald CM. Depression in adults who sustained spinal cord injuries as children or adolescents. J Spinal Cord Med. 2007;30:S76-82.
,
Depression in adults who sustained spinal cord injuries as children or adolescents
, J Spinal Cord Med.
, vol. 30
Anderson CJ, Kelly EH, Klaas SJ, Russell H, Daharsh E, Vogel LC. Anxiety and depression in children and adolescents with spinal cord injuries. Dev Med Child Neurol. 2009;51:826-832.
,
Anxiety and depression in children and adolescents with spinal cord injuries
, Dev Med Child Neurol.
, vol. 51
Elliott TR, Frank, RG. Depression following spinal cord injury. Arch Phys Med Rehabil. 1996;77(8):816–823.
,
Depression following spinal cord injury
, Arch Phys Med Rehabil.
, vol. 77
(pg. 816
-823
) Burns S, Biering-Sorenson F, Donovan W, et al. International standards for neurological classification of spinal cord injury, revised 2011. Top Spinal Cord Inj Rehabil. 2012;18(1):88-99.
,
International standards for neurological classification of spinal cord injury, revised 2011
, Top Spinal Cord Inj Rehabil.
, vol. 18
Kovacs M. Children’s Depression Inventory (CDI): Technical Manual Update. North Tonawanda, New York: Multi-Health Systems; 2003.
,
Children’s Depression Inventory (CDI): Technical Manual Update.
Beck A., Steer RA, Brown GK. Beck Depression Inventory- Second Edition (BDI-II): Manual. San Antonio, TX: Psychological Corp; 1996.
,
Beck Depression Inventory- Second Edition (BDI-II): Manual.
Reynolds CR, Richmond BO. Revised Children’s Manifest Anxiety Scale (RCMAS): Manual. Los Angeles, CA: Western Psychological Services; 2000.
,
Revised Children’s Manifest Anxiety Scale (RCMAS): Manual.
Pett MA. Nonparametric Statistics for Health Care Research. Thousand Oaks, CA: Sage Publications; 1997.
,
Nonparametric Statistics for Health Care Research.
American Spinal Injury Association. Reference Manual for the International Classification of Spinal Cord Injury. Atlanta: Author; 2011.
,
American Spinal Injury Association
, Reference Manual for the International Classification of Spinal Cord Injury.
Fann JR, Bombardier CH, Richards JS, Tate DG, Wilson CS, Temkin N. Depression after spinal cord injury: Comorbidities, mental health service use, and adequacy of treatment. Arch Phys Med Rehabil. 2011;92:352-360.
,
Depression after spinal cord injury: Comorbidities, mental health service use, and adequacy of treatment
, Arch Phys Med Rehabil.
, vol. 92
Farmer TJ. The experience of major depression: Adolescents’ perspectives. Issues Mental Health Nurs. 2002;22:567-585.
,
The experience of major depression: Adolescents’ perspectives
, Issues Mental Health Nurs.
, vol. 22
Han PP, Holbrook TL, Sise MJ, et al. Post-injury depression is a serious complication in adolescents after major trauma: Injury severity and injury-event factors predict depression and long-term quality of life deficits. J Trauma. 2011; 70(4):923-930.
,
Post-injury depression is a serious complication in adolescents after major trauma: Injury severity and injury-event factors predict depression and long-term quality of life deficits
, J Trauma.
, vol. 70
Merikangas KR, Avenevoli S. Epidemiology of mood and anxiety disorders in children and adolescents. In: Tsaung MT, Tohen M, eds. Textbook in Psychiatric Epidemiology (2nd ed). New York: Wiley-Liss; 2002:657–704.
,
Epidemiology of mood and anxiety disorders in children and adolescents. In
, Textbook in Psychiatric Epidemiology.
(pg. 657
-704
) Substance Abuse and Mental Health Services Administration, Office of Applied Studies. National Survey on Drug Use and Health. Rockville, MD: Author; 2006.
,
Substance Abuse and Mental Health Services Administration, Office of Applied Studies
, National Survey on Drug Use and Health.
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