Depression in adults who sustained spinal cord injuries as children or adolescents

Objective: To assess depression in adults with pediatric-onset spinal cord injuries (SCI) and to determine demographic and injury-related factors, and outcomes associated with depression, and to determine which other outcomes are associated with depression. Methods: Subjects were adults with pediatric-onset SCI who sustained SCI at age <= 18 years and were interviewed at age >= 24 years. This is part of a longitudinal study for which there were 864 eligible participants; 353 (41 %) were interviewed. Of these, 232 were assessed for depression. A telephone interview was conducted that included a structured questionnaire and standardized measures (Functional Independence Measure, Craig Handicap Assessment and Reporting Technique, Short-Form 12 measure of health-related quality of life, Satisfaction with Life Scale, and Patient Health Questionnaire-9 to screen for depression). Results: Twenty-seven percent reported depressive symptoms ranging from mild to severe, and 7% reported having suicidal thoughts within the last 2 weeks, and 3% reported symptoms consistent with probable major depressive disorder (MDD). Depression was not significantly associated with any demographic factors but it was associated with incomplete injury (P = 0.013). Depression was also associated with many participation outcomes, health-related quality of life, life satisfaction, and medical complications. Conclusions: Depression is a significant problem among adults with pediatric-onset SCI and is associated with poorer outcomes and lower quality of life. These findings should be addressed as clinicians prepare children and adolescents with SCI to transition to adulthood.