Depression in individuals with spinal cord injury: methodological issues.

The methodological problems in research related to depression in individuals with spinal cord injury (SCI) are examined. These include relation to normal emotional reactions following injury, the use of physical and vegetative symptoms in the diagnosis of depression, the utilisation of rating scales primarily designed for use in psychiatric populations, the heterogeneity of patients with SCI, the role of preexisting psychiatric morbidity, the selection of controls for comparison and the necessity for multivariate statistical approaches to analysis. The issues and possible solutions are discussed.