Charles H Bombardier1, Leah M Adams2, Jesse R Fann3, Jeanne M Hoffman4. 1. Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA. Electronic address: chb@uw.edu. 2. Group Health Research Institute, Seattle, WA. 3. Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA. 4. Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA.
Abstract
OBJECTIVE: To determine the number and type of longitudinal depression trajectories during the first year after spinal cord injury (SCI) and to identify baseline predictors of these trajectories. DESIGN: Cohort study. SETTING: Rehabilitation and postacute community settings. PARTICIPANTS: Of 168 consecutive admissions to inpatient rehabilitation for acute SCI, 141 (115 men, 26 women) patients were enrolled in a randomized controlled trial telephone follow-up intervention, which showed no outcome differences, and completed assessments on at least 2 of the 4 follow-up occasions (3, 6, 9, and 12 months after SCI). Participants were on average 41 years old, most were non-Hispanic (96%) and white (86%), and 61.7% had tetraplegia. INTERVENTIONS: Data were drawn from the ineffective randomized controlled trial. MAIN OUTCOME MEASURE: Patient Health Questionnaire-9 (PHQ-9). RESULTS: Unconditional linear latent class growth analysis models of PHQ-9 total scores revealed an optimal 3-class solution: stable low depression (63.8%), mild to moderate depression (29.1%), and persistent moderate to severe depression (7.1%). Preinjury mental health history and baseline pain, quality of life, and grief predicted class membership. CONCLUSIONS: The modal response to SCI was stable low depression, whereas persistent moderate to severe depression primarily represented a continuation or relapse of preinjury depression. This line of research has the potential to improve identification of subgroups destined for poor outcomes and to inform early intervention studies.
RCT Entities:
OBJECTIVE: To determine the number and type of longitudinal depression trajectories during the first year after spinal cord injury (SCI) and to identify baseline predictors of these trajectories. DESIGN: Cohort study. SETTING: Rehabilitation and postacute community settings. PARTICIPANTS: Of 168 consecutive admissions to inpatient rehabilitation for acute SCI, 141 (115 men, 26 women) patients were enrolled in a randomized controlled trial telephone follow-up intervention, which showed no outcome differences, and completed assessments on at least 2 of the 4 follow-up occasions (3, 6, 9, and 12 months after SCI). Participants were on average 41 years old, most were non-Hispanic (96%) and white (86%), and 61.7% had tetraplegia. INTERVENTIONS: Data were drawn from the ineffective randomized controlled trial. MAIN OUTCOME MEASURE: Patient Health Questionnaire-9 (PHQ-9). RESULTS: Unconditional linear latent class growth analysis models of PHQ-9 total scores revealed an optimal 3-class solution: stable low depression (63.8%), mild to moderate depression (29.1%), and persistent moderate to severe depression (7.1%). Preinjury mental health history and baseline pain, quality of life, and grief predicted class membership. CONCLUSIONS: The modal response to SCI was stable low depression, whereas persistent moderate to severe depression primarily represented a continuation or relapse of preinjury depression. This line of research has the potential to improve identification of subgroups destined for poor outcomes and to inform early intervention studies.
Authors: Daniel W Klyce; Charles H Bombardier; Trevor J Davis; Narineh Hartoonian; Jeanne M Hoffman; Jesse R Fann; Claire Z Kalpakjian Journal: Arch Phys Med Rehabil Date: 2015-03-03 Impact factor: 3.966
Authors: Jesse R Fann; Charles H Bombardier; J Scott Richards; Catherine S Wilson; Allen W Heinemann; Ann Marie Warren; Larry Brooks; Cheryl B McCullumsmith; Nancy R Temkin; Catherine Warms; Denise G Tate Journal: JAMA Psychiatry Date: 2015-03 Impact factor: 21.596
Authors: Charles H Bombardier; Casey B Azuero; Jesse R Fann; Donald D Kautz; J Scott Richards; Sunil Sabharwal Journal: Top Spinal Cord Inj Rehabil Date: 2021
Authors: Sander L Hitzig; Rebecca Titman; Steven Orenczuk; Teren Clarke; Heather Flett; Vanessa K Noonan; Patricia Bain; Sandra Mills; Farnoosh Farahani; Matheus Joner Wiest; Gaya Jeyathevan; S Mohammad Alavinia; B Catharine Craven Journal: J Spinal Cord Med Date: 2019-10 Impact factor: 1.985