Identifying Depression Severity Risk Factors in Persons With Traumatic Spinal Cord Injury

Purpose/Objective: Examine the relationship between demographic characteristics, health-, and injury-related characteristics, and substance misuse across multiple levels of depression severity. Research Method/Design: 204 persons with traumatic spinal cord injury (SCI) volunteered as part of screeni...

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Bibliographic Details
Published in:Rehabilitation psychology 2014-02, Vol.59 (1), p.50-56
Main Authors: Williams, Ryan T, Wilson, Catherine S, Heinemann, Allen W, Lazowski, Linda E, Fann, Jesse R, Bombardier, Charles H
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Attitude to Health
Depressive Disorder - complications
Depressive Disorder - diagnosis
Depressive Disorder - psychology
Educational Status
Female
Health
Human
Humans
Major Depression
Male
Middle Aged
Patients
Psychiatric Status Rating Scales - statistics & numerical data
Questionnaires
Rehabilitation
Risk Assessment - methods
Risk Assessment - statistics & numerical data
Risk Factors
Screening
Severity (Disorders)
Severity of Illness Index
Spinal Cord Injuries
Spinal Cord Injuries - complications
Spinal Cord Injuries - psychology
Substance-Related Disorders - complications
Substance-Related Disorders - diagnosis
Substance-Related Disorders - psychology
Surveys and Questionnaires
Young Adult
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Summary:Purpose/Objective: Examine the relationship between demographic characteristics, health-, and injury-related characteristics, and substance misuse across multiple levels of depression severity. Research Method/Design: 204 persons with traumatic spinal cord injury (SCI) volunteered as part of screening efforts for a randomized controlled trial of venlafaxine extended release for major depressive disorder (MDD). Instruments included the Patient Health Questionnaire-9 (PHQ-9) depression scale, the Alcohol Use Disorders Identification Test (AUDIT), and the Substance Abuse in Vocational Rehabilitation-Screener (SAVR-S), which contains 3 subscales: drug misuse, alcohol misuse, and a subtle items scale. Each of the SAVR-S subscales contributes to an overall substance use disorder (SUD) outcome. Three proportional odds models were specified, varying the substance misuse measure included in each model. Results: 44% individuals had no depression symptoms, 31% had mild symptoms, 16% had moderate symptoms, 6% had moderately severe symptoms, and 3% had severe depression symptoms. Alcohol misuse, as indicated by the AUDIT and the SAVR-S drug misuse subscale scores were significant predictors of depression symptom severity. The SAVR-S substance use disorder (SUD) screening outcome was the most predictive variable. Level of education was only significantly predictive of depression severity in the model using the AUDIT alcohol misuse indicator. Conclusions/Implications: Likely SUD as measured by the SAVR-S was most predictive of depression symptom severity in this sample of persons with traumatic SCI. Drug and alcohol screening are important for identifying individuals at risk for depression, but screening for both may be optimal. Further research is needed on risk and protective factors for depression, including psychosocial characteristics.
ISSN:0090-5550
1939-1544
DOI:10.1037/a0034904