Background: Research has documented high rates of depression in people with spinal cord injury (SCI); however, most SCI research is conducted with predominantly male study participants. Additional research is needed on depression and depression treatment among women with SCI. Objective: Study objectives were to examine depression, correlates of depression, and depression treatment in a sample of women with SCI. Methods: The sample included 51 ethnically and racially diverse women with SCI who participated in a larger study on secondary conditions of women with diverse physical disabilities. Recruited through health clinics and community organizations in a large metropolitan area, participants completed structured interviews that included demographic and disability characteristics and measures of health and health care utilization. Results: Scores on the Beck Depression Inventory–II (BDI-II) indicated that 41% of the women had depressive symptomatology in the mild to severe range. BDI-II scores were significantly related to more severe secondary conditions, greater pain, and poorer health perceptions but not to demographic or disability variables. Nearly a third (n = 16) of the women had scores exceeding the standard cutoff for significant clinical depressive symptomatology, yet only 5 of those had received any treatment for depression in the past 3 months and only 1 had received counseling or psychotherapy. Lifelong depression treatment showed a similar pattern of predominantly pharmacologic treatment. Conclusion: Depression is a common problem for women with SCI, and many do not receive treatment, particularly psychological treatment. Disability-sensitive and affordable depression treatment must be made available to women with SCI.

Craig A, Tran Y, Middleton J. Psychological morbidity and spinal cord injury: A systematic review. Spinal Cord. 2009;47:108–114.
,
Psychological morbidity and spinal cord injury: A systematic review.
,
Spinal Cord.
, vol.
47
(pg.
108
-
114
)
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
)
Fann JR, Bombardier CH, Richards JS, Tate DG, Wilson CS, Temkin NR. 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
(pg.
352
-
360
)
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;92:411–418.
,
A longitudinal study of depression from 1 to 5 years after spinal cord injury.
,
Arch Phys Med Rehabil.
, vol.
92
(pg.
411
-
418
)
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
(pg.
1099
-
1109
)
Post MWM, van Leeuwen CMC. Psychosocial issues in spinal cord injury: A review. Spinal Cord. 2012;50(5):382–389.
,
Psychosocial issues in spinal cord injury: A review.
,
Spinal Cord.
, vol.
50
(pg.
382
-
389
)
National Spinal Cord Injury Model Systems. Spinal cord injury facts and figures at a glance. https://www.nscisc.uab.edu/PublicDocuments/fact_figures_docs/Facts%202013.pdf. Accessed April 17, 2013 https://www.nscisc.uab.edu/PublicDocuments/fact_figures_docs/Facts%202013.pdf.
Hughes RB, Swedlund N, Petersen N, Nosek MA. Depression and women with spinal cord injury. Top Spinal Cord Inj Rehabil. 2001;7(1):16–24.
,
Depression and women with spinal cord injury.
,
Top Spinal Cord Inj Rehabil.
, vol.
7
(pg.
16
-
24
)
Arango-Lasprilla JC, Ketchum KM, Starkweather A, Nicholls 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
(pg.
9
-
21
)
Krause JS, Broderick L. Outcomes after spinal cord injury: comparisons as a function of gender and race and ethnicity. Arch Phys Med Rehabil. 2004;85(3):355–362.
,
Outcomes after spinal cord injury: comparisons as a function of gender and race and ethnicity.
,
Arch Phys Med Rehabil.
, vol.
85
(pg.
355
-
362
)
Krause JS, Brotherton SS, Morrisette DC, Newman SD, Karakostas TE. Does pain interference mediate the relationship of independence in ambulation with depressive symptoms after spinal cord injury? Rehabil Psychol. 2007;52(2):162–169.
,
Does pain interference mediate the relationship of independence in ambulation with depressive symptoms after spinal cord injury?
,
Rehabil Psychol.
, vol.
52
(pg.
162
-
169
)
Kalpakjian CZ, Albright KJ. An examination of depression through the lens of spinal cord injury: Comparative prevalence rates and severity in women and men. Womens Health Issues. 2006;16:380–388.
,
An examination of depression through the lens of spinal cord injury: Comparative prevalence rates and severity in women and men.
,
Womens Health Issues.
, vol.
16
(pg.
380
-
388
)
Woolrich RA, Kennedy P, Tasiemski T. A preliminatey psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) in 963 people living with a spinal cord injury. Psychol Health Med. 2006;11(1):80–90.
,
A preliminatey psychometric evaluation of the Hospital Anxiety and Depression Scale (HADS) in 963 people living with a spinal cord injury.
,
Psychol Health Med.
, vol.
11
(pg.
80
-
90
)
Bombardier CH, Fann JR, Tate DG, et al.; PRISMS Investigators. An exploration of modifiable risk factors for depression after spinal cord injury: Which factors should we target? Arch Phys Med Rehabil. 2012;93(5):775–781.
,
PRISMS Investigators. An exploration of modifiable risk factors for depression after spinal cord injury: Which factors should we target?
,
Arch Phys Med Rehabil.
, vol.
93
(pg.
775
-
781
)
Elliott TR, Kennedy P. Treatment of depression following spinal cord injury: An evidence-based review. Rehab Psychol. 2004;49(2):134–139.
,
Treatment of depression following spinal cord injury: An evidence-based review.
,
Rehab Psychol.
, vol.
49
(pg.
134
-
139
)
Consortium for Spinal Cord Medicine. Depression following spinal cord injury: A clinical practice guideline for primary care physicians. http://www.metrohealth.org/documents/patient%20services/norscis/Depression.pdf. Accessed on April 17, 2013 http://www.metrohealth.org/documents/patient%20services/norscis/Depression.pdf
Ware JE, Sherbourne CD. The MOS 36-item short form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–483.
,
The MOS 36-item short form health survey (SF-36). I. Conceptual framework and item selection.
,
Med Care.
, vol.
30
(pg.
473
-
483
)
Ware JE, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Lincoln, RI: QualityMetric Inc; 2000.
,
SF-36 Health Survey Manual and Interpretation Guide.
Ravesloot C, Seekins T, Walsh J. A structural analysis of secondary conditions experienced by people with physical disabilities. Rehabil Psychol. 1997;42(1):3–16.
,
A structural analysis of secondary conditions experienced by people with physical disabilities.
,
Rehabil Psychol.
, vol.
42
(pg.
3
-
16
)
Beck AT, Steer RA, Brown GK. Manual for Beck Depression Inventory–II. San Antonio, TX: Psychological Corp; 1996.
,
Manual for Beck Depression Inventory–II.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: Author; 1994.
,
American Psychiatric Association
,
Diagnostic and Statistical Manual of Mental Disorders.
Segal DL, Coolidge FL, Cahill BS, O’Riley AA. Psychometric properties of the Beck Depression Inventory II (BDI-II) among community-dwelling older adults. Behav Modif. 2008;32(1):3–20.
,
Psychometric properties of the Beck Depression Inventory II (BDI-II) among community-dwelling older adults.
,
Behav Modif.
, vol.
32
(pg.
3
-
20
)
Mackenzie CS, Reynolds K, Cairney J, Streiner DL, Sareen J. Disorder-specific mental health service use for mood and anxiety disorders: Associations with age, sex, and psychiatric comorbidity. Depress Anxiety. 2012;29(3):234–242.
,
Disorder-specific mental health service use for mood and anxiety disorders: Associations with age, sex, and psychiatric comorbidity.
,
Depress Anxiety.
, vol.
29
(pg.
234
-
242
)
Wang PS, Lane M, Olfson M, Pincus HA, Wells KB, Kessler RC. Twelve-month use of mental health services in the United States. Arch Gen Psychiatry. 2005;62(6):629–640.
,
Twelve-month use of mental health services in the United States.
,
Arch Gen Psychiatry.
, vol.
62
(pg.
629
-
640
)
Reece JC, Chan YF, Herbert J, Gralow J, Fann JR. Course of depression, mental health service utilization and treatment preferences in women receiving chemotherapy for breast cancer. Gen Hosp Psychiatry. 2013;35(4):376–381.
,
Course of depression, mental health service utilization and treatment preferences in women receiving chemotherapy for breast cancer
,
Gen Hosp Psychiatry.
, vol.
35
(pg.
376
-
381
)
Pampallona S, Bollini P, Tibaldi G, Kupelnick B, Munizza C. Combined pharmacotherapy and psychological treatment for depression: A systematic review. Arch Gen Psychiatry. 2004;61(7):714–719.
,
Combined pharmacotherapy and psychological treatment for depression: A systematic review.
,
Arch Gen Psychiatry.
, vol.
61
(pg.
714
-
719
)
Griffiths KM, Christensen H, Jorm AF. Predictors of depression stigma. BMC Psychiatry. 2008;8:25–36.
,
Predictors of depression stigma.
,
BMC Psychiatry.
, vol.
8
(pg.
25
-
36
)
Pennix BW, Millaneschi Y, Lamers F, Vogelzangs N. Understanding the somatic consequences of depression: Biological mechanisms and the role of depression symptom profile. BMC Med. 2013;11:129.
,
Understanding the somatic consequences of depression: Biological mechanisms and the role of depression symptom profile.
,
BMC Med.
, vol.
11
Garamszegi LZ. Comparing effect sizes across variables: Generalization without the need for Bonferroni correction. Behav Ecol. 2006;17(4):682–687.
,
Comparing effect sizes across variables: Generalization without the need for Bonferroni correction.
,
Behav Ecol.
, vol.
17
(pg.
682
-
687
)
Cohen J. Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum; 1988.
,
Statistical Power Analysis for the Behavioral Sciences.
Wood RG, Goesling B, Avellar S. The Effects of Marriage on Health: A Synthesis of Recent Research Evidence. Washington DC: Mathematica Policy Research, Inc.; 2007.
,
The Effects of Marriage on Health: A Synthesis of Recent Research Evidence.
Shin JC, Goo HR, Yu SJ, Kim DH, Yoon SY. Depression and quality of life in patients within the first 6 months after the spinal cord injury. Ann Rehabil Med. 2012;36:119–125.
,
Depression and quality of life in patients within the first 6 months after the spinal cord injury.
,
Ann Rehabil Med.
, vol.
36
(pg.
119
-
125
)
Kalpakjian CZ, Houlihan B, Meade M, et al. Marital status, marital transitions, well-being, and spinal cord injury: An examination of the effects of sex and time. Arch Phys Med Rehabil. 2011;92(3):433–440.
,
Marital status, marital transitions, well-being, and spinal cord injury: An examination of the effects of sex and time.
,
Arch Phys Med Rehabil.
, vol.
92
(pg.
433
-
440
)
Robinson-Whelen S, Hughes RB, Taylor HB, Hall JW, Rehm LP. Depression self-management program for rural women with physical disabilities. Rehabil Psychol. 2007;52:254–262.
,
Depression self-management program for rural women with physical disabilities.
,
Rehabil Psychol.
, vol.
52
(pg.
254
-
262
)
This content is only available as a PDF.