Rehabilitation outcomes in people with pre-morbid mental health disorders following spinal cord injury

Abstract

Study design:Case series, consecutive sample.Objective:To investigate the rehabilitation outcomes of patients with spinal cord injury (SCI) suffering from preexisting mental health disorders (MHD).Setting:National Spinal Injuries Centre (NSIC), Stoke Mandeville Hospital, UK.Method:Twenty-eight newly injured SCI patients: 14 with preexisting MHD and a matched cohort of 14 patients without MHD who were admitted between 2000 and 2006. All patients were involved in a multidisciplinary Goal Planning and Needs Assessment Rehabilitation Programme. Rehabilitation outcomes were measured using the Needs Assessment Checklist (NAC), which has been specifically designed for use with people with SCI. It is a reliable and valid clinical assessment tool, which provides a means to assess and facilitate the delivery of an individually tailored rehabilitation programme.Results:No significant difference was found between the MHD and non-MHD groups for rehabilitation outcomes. The MHD group showed higher achieved independence scores in psychology for the first needs assessment. Overall, both groups were found to make significant improvements in their level of independence for all nine areas of need between the first and second NAC administration.Conclusion:Results suggest that rehabilitation can be tailored to meet the individual needs of patients with SCI having MHD; however, further research comparing these outcomes with other rehabilitation approaches is required. The function of timely psychological support for MHD patients on admission to the NSIC has been suggested as a potential explanation for rehabilitation performance. Most importantly, rehabilitation outcomes of patients with MHD have not been found to differ significantly compared with those without MHD. © 2009 International Spinal Cord Society.