Ullrich Philip M, Smith Bridget M, Blow Frederic C, Valenstein Marcia, Weaver Frances M
J Spinal Cord Med. 2014 Jan;37(1):40-5. doi: 10.1179/2045772313Y.0000000137. Epub 2013 Nov 26.
Depression is often comorbid with other psychiatric conditions in the general population, with resultant impact on severity of conditions and healthcare utilization. It is unclear to what degree this is also true among persons with spinal cord injury (SCI).
This study examined rates at which psychiatric conditions were comorbid with depression after SCI, and the association between a depression diagnosis and healthcare and pharmaceutical drug use.
Retrospective analysis of data (N = 41 213) abstracted from Veterans Health Administration administrative databases between fiscal years (FYs) 1997 and 2007 to examine overall rates of depression. Administrative data from FY 2007 was used to examine rates of psychiatric disorders comorbid with depression, and to compare veterans with SCI and depression to veterans with SCI but no depression on healthcare and pharmaceutical use.
Twenty-eight percent (n = 11 506) of 41 213 veterans who received SCI care between FY 1997 and FY 2007 were diagnosed with depressive disorders. Among the veterans with SCI and depression diagnoses in 2007 (n = 2615), 70% were also diagnosed with another psychiatric illness, with posttraumatic stress disorder and other anxiety disorders being the most common. Veterans with SCI and depression had more healthcare visits and received more pharmaceutical prescriptions than their counterparts without depression.
Persons with SCI and depression are likely to experience comorbid psychiatric illnesses, with associated increased healthcare visits and medication use. Research and theory on depression after SCI should develop toward describing and addressing psychiatric and medical co-morbidities that are normative in this population.
在普通人群中，抑郁症常与其他精神疾病共病，这会对病情严重程度和医疗保健利用产生影响。目前尚不清楚在脊髓损伤（SCI）患者中这种情况的真实程度。
本研究调查了脊髓损伤后精神疾病与抑郁症共病的发生率，以及抑郁症诊断与医疗保健和药物使用之间的关联。
对1997财年至2007财年从退伍军人健康管理局行政数据库中提取的数据（N = 41213）进行回顾性分析，以检查抑郁症的总体发生率。使用2007财年的行政数据来检查与抑郁症共病的精神障碍发生率，并比较患有脊髓损伤和抑郁症的退伍军人与患有脊髓损伤但无抑郁症的退伍军人在医疗保健和药物使用方面的情况。
在1997财年至2007财年期间接受脊髓损伤护理的41213名退伍军人中，28%（n = 11506）被诊断患有抑郁症。在2007年被诊断患有脊髓损伤和抑郁症的退伍军人中（n = 2615），70%还被诊断患有另一种精神疾病，其中创伤后应激障碍和其他焦虑症最为常见。患有脊髓损伤和抑郁症的退伍军人比没有抑郁症的退伍军人有更多的医疗就诊次数，并且接受了更多的药物处方。
患有脊髓损伤和抑郁症的人可能会经历共病的精神疾病，这会导致医疗就诊次数和药物使用增加。脊髓损伤后抑郁症的研究和理论应朝着描述和解决该人群中常见的精神和医学共病发展。
