Depression and quality of life in spinal cord injury patients living in the community after hospital discharge

Abstract

Objective: To investigate quality of life (QoL) and the prevalence of depression, and to identify factors significantly associated with QoL and depression in spinal cord injury (SCI) patients living in the community after hospital discharge. Methods: This prospective study included SCI patients that have a follow-up evaluation and care at the Siriraj Spinal Unit of the Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand during April 2015 to February 2018. Presence and level of depression and QoL were assessed using Patient Health Questionnaire-9 (PHQ-9) and World Health Organization Quality of Life Brief-Thai (WHOQOL-BREFTHAI), respectively. Age, gender, education level, income, marital status, level of impairment, injury severity, cause of injury, and time since injury were collected and recorded. Results: One hundred and twelve spinal injury patients (64.3% male) with a mean age of 44.3±15.3 years were enrolled. The prevalence of depression was 39.3%, and the mean overall QoL was a moderate 90.3±14.7. Multivariate analysis revealed marital status to be the only independent predictor of depression after hospital discharge (odds ratio [OR]: 2.99, 95% confidence interval [CI]: 1.19-7.51; p=0.020). Regarding QoL, multivariate analysis revealed educational level (OR: 16.18, 95% CI: 3.01-87.03; p=0.001), level of impairment (OR: 9.20, 95% CI: 1.84-46.13; p=0.007), and depression (OR: 50.39, 95% CI: 7.94-319.83; p<0.001) to be independent predictors of quality of life. Conclusion: Depression was observed in 39.3% of SCI, and most study patients had moderate QoL. Marital status predicts depression; and, educational level, level of impairment, and presence of depression predict QoL.