Review

Spinal Cord (2013) 51, 260–266; doi:10.1038/sc.2013.3; published online 18 February 2013

The influence of depression on physical complications in spinal cord injury: behavioral mechanisms and health-care implications

H Krueger1,2, V K Noonan3,4, D Williams2, L M Trenaman2 and C S Rivers4

  1. 1UBC School of Population and Public Health, The Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
  2. 2H Krueger & Associates Inc., Delta, British Columbia, Canada
  3. 3Division of Spine, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada
  4. 4Rick Hansen Institute, Vancouver, British Columbia, Canada

Correspondence: Dr CS Rivers, Rick Hansen Institute, 6th Floor, Blusson Spinal Cord Centre, 818 West 10th Avenue, Vancouver, British Columbia, Canada V5Z 1M9. E-mail: crivers@rickhanseninstitute.org

Received 6 July 2012; Revised 4 January 2013; Accepted 13 January 2013
Advance online publication 18 February 2013

Top

Abstract

Study Design:

 

This study is a literature review and a proposed conceptual model.

Objectives:

 

The objective of this study is to develop a conceptual model to explore the relationship between the presence of depressive symptoms and secondary physical complications such as pressure ulcers, urinary tract infections and autonomic dysreflexia in spinal cord injury (SCI).

Setting:

 

Community setting for individuals with SCI.

Methods:

 

A conceptual model explaining the mechanism underlying the relationship between depression and secondary physical SCI complications was developed based on the International Classification of Functioning, Disability and Health (ICF). A literature review was conducted to develop the model and to identify potential mechanisms responsible for the association.

Results:

 

A conceptual model based on ICF was created, informed by the literature discussing the link between depression and secondary physical SCI complications. Evidence in the literature was located that supports both a causal connection between depression and increased physical complications and/or the potential mechanisms mediating that connection.

Conclusion:

 

The proposed model can be utilized to encourage further research on the influence of depression on SCI outcomes and the importance of prompt and effective identification and treatment of depressive symptoms. Additional research is needed to assess the relationship between depression and secondary physical SCI complications, and to test the validity of the model.

Keywords:

spinal cord injury; depression; complications; pressure ulcers; conceptual model; International Classification of Functioning, Disability and Health