Indicators of psychological distress in postacute spinal cord injured individuals

Study design: Consecutive inclusion of spinal cord injured patients admitted for postacute rehabilitation from June 2000 to January 2002. Objective: Assessment of prevalence of indicators of psychological distress in the subacute and early chronic stages after acute-onset spinal cord injury (SCI). Setting: A Swedish rehabilitation center. Methods: In all, 36 patients participated. Psychological assessment was obtained at admission, discharge and 6 months follow-up by psychological measures based on the DSM-IV (ie Beck's Depression Inventory, SPIFA, SCID-screen, AUDIT) and clinical interview. Ongoing psychotropic medication was noted. Results: Clinical depression was infrequent. However, ongoing psychotropic medication was common, possibly indicating a relatively high incidence of underlying depressive and anxiety disorders. In all, 25% of the sample showed indicators of high alcohol consumption. Few patients had a previously diagnosed personality disorder. By contrast, there was frequent occurrence of personality traits outside normal ranges. Conclusion: Medication of psychological problems commonly occurs after SCI, especially for depression and anxiety. There are indications of alcohol overconsumption in a substantial minority of SCI patients. The study raises the question of whether suppression of psychological symptoms by drug therapy is the optimal treatment of such problems in a rehabilitation process.