Spinal cord injury and mental health

Objectives: The aim of the study was to examine the mental health of adults with spinal cord injury living in the community Methods: The study was a representative community cross-sectional cohort self-report survey, carried out in adults with traumatic spinal cord injury registered on the Victorian Spinal Cord Injury Register and adults with non-traumatic spinal cord injury attending a specialist non-traumatic spinal cord injury rehabilitation clinic. Participants ( n = 443) completed a self-report survey by internet, telephone or hard copy, which used reliable and valid measures of depression, anxiety and stress ( Depression, Anxiety and Stress Scale) and post-traumatic stress disorder ( Impact of Events Scale-Revised). Results: Nearly half ( 48.5%) of the population with spinal cord injury suffered mental health problems of depression ( 37%), anxiety ( 30%), clinical-level stress ( 25%) or post-traumatic stress disorder ( 8.4%). Overall, there was a twofold or more increase in the probability of emotional disorders compared to the general population. Of those with one mental health disorder, 60% also had at least one other emotional disorder, representing a substantial 56% increase over the general population in the probability of comorbidity of psychopathology. Better health and time since injury were associated with decreasing the risk of psychopathology. Conclusion: The results of the present study underscore the vulnerability of the population with spinal cord injury to emotional disorders. This study highlights the complexity of mental health problems experienced by many individuals with spinal cord injury living in the community. The delivery of mental health services to this vulnerable population requires recognition of comorbidity and problems of mobility, access and stigma.