DEPRESSION IN PATIENT WITH SPINAL INJURY AND IT'S CORRELATION WITH QUALITY OF LIFE AND SECONDARY COMPLICATIONS
ABSTRACT
Background
Spinal Injury patients face more difficulties in a hilly and mountainous geography. The future prospect in a place where roads and other infrastructures for the patients are lacking is disappointing which predisposes more to illness like depression.
Objective
The prevalence of depression in spinal injury patients were seen in a rehabilitation center. The correlation of depression with Quality of Life ( QOL), secondary complications and other demographic profiles was also observed.
Methodology
A cross sectional study was done in 70 inpatients of a rehabilitation center in Nepal. General Health Questionnaire was initially applied and patients with case positiveness were screened for depression using Hamilton Depression Rating Scale (HDRS). Patients who showed depression in HDRS were evaluated using ICD 10 DCR. Short Form 36 was used to measure QOL; American Spinal Injury Association Classification was used to grade the spinal injury and a semi structured proforma was used to gather the demographic profiles and secondary complications. Chi square test was applied for categorical data and odds ratio was measured where appropriate.
Results
Depressive disorder was seen in 30% of 70 patients. 60% patients were from 21 to 40yrs of age; 67.1% were male; 75.7% married with most of the patients with education primary level or below. The most common cause of injury was fall from height and bed sores were the most common secondary complication being present in 15.7% patients. The secondary complications and demographic characters did not have statistically
significant relationship with depression. The mental QOL had a significant relationship with depression with p value of 0.00.
Conclusion
The presence of depression in a large group of in SCI patients as compared to the general population and its impact in outcome and the quality of life cannot be neglected. The need of routine evaluation of SCI patients by a mental health professional to rule out mental disorder need not be overemphasized. Further researches and follow up studies in a country like Nepal would help to bring the issues of mental health in SCI patients into
limelight as this aspect is not well addressed in this part of geography.
Author: Dr. Rishav Koirala