Migliorini C, Sinclair A, Brown D, Tonge B, New P
Centre for Developmental Psychiatry and Psychology, Monash University, Melbourne, Victoria, Australia.
Department of Occupational Therapy, Monash University, Melbourne, Victoria, Australia.
Intern Med J. 2015 Oct;45(10):1014-9. doi: 10.1111/imj.12825.
There is little understanding of the prevalence of mental health issues in people with spinal cord injury (SCI) after they leave rehabilitation or how mental health issues can alter over time.
The aims were to (i) determine the prevalence of mood disturbance in adults with chronic SCI living in the community, (ii) ascertain whether the prevalence of mood disturbance had changed since a previous study in 2004-2005 and (iii) establish whether people with chronic SCI remain vulnerable to mood disturbance, irrespective of time since injury.
Prospective, open-cohort case series. Participants were 573 community-based adults with a chronic SCI. The depression, anxiety and stress scale - short version was used. Analyses included simple descriptors, Chi-squared and repeated measures t-tests.
Nearly half of participants (n = 263/573; 46%) reported symptoms indicating mood disturbance, which was similar to the level found in the previous study. While the presence of mood disturbance persisted in 23% of adults (n = 26) and 46 (41%) were in the 'below threshold' category, just over a third of the adults who participated in both studies (n = 111) experienced a change (n = 21, 19% mood disturbance resolved and n = 18, 16% mood disturbance developed).
Both resilience and change are common. At no time after SCI is the risk of mental health problems considered reduced or even stable. These results highlight the importance of regular mental health reviews even in those who have previously displayed good resilience.
对于脊髓损伤（SCI）患者康复出院后的心理健康问题患病率，以及心理健康问题如何随时间变化，人们了解甚少。
旨在（i）确定居住在社区的慢性SCI成年患者中情绪障碍的患病率，（ii）确定自2004 - 2005年的一项先前研究以来，情绪障碍的患病率是否发生了变化，以及（iii）确定慢性SCI患者是否无论受伤时间多久，仍易患情绪障碍。
前瞻性、开放队列病例系列研究。参与者为573名社区慢性SCI成年患者。使用了抑郁、焦虑和压力量表简版。分析包括简单描述、卡方检验和重复测量t检验。
近一半参与者（n = 263/573；46%）报告有表明情绪障碍的症状，这与先前研究中发现的水平相似。虽然23%的成年人（n = 26）持续存在情绪障碍，46人（41%）处于“低于阈值”类别，但参与两项研究的成年人中略超过三分之一（n = 111）经历了变化（n = 21，19%情绪障碍缓解；n = 18，16%出现情绪障碍）。
恢复力和变化都很常见。SCI后的任何时候，心理健康问题的风险都未被认为降低甚至稳定。这些结果凸显了即使对那些先前表现出良好恢复力的人进行定期心理健康评估的重要性。
