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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spinal cord injuries (SCI) often have psychological consequences, primarily anxiety and depression, which may interfere with rehabilitation possibilities, with adjustment to the impairment and therefore with the possibility of returning to previous familiar social life and work. To assess the degree of anxiety and depression in SCI patients, and to study the factors contributing to their genesis, 100 SCI in- and out-patients were administered questionnaires for self-rating anxiety and depression. A group of newly injured patients was followed up for a year after their discharge to study the evolution of the two psychological syndromes. These two psychological pathologies in SCI patients were respectively 13% (anxiety) and 16% (depression). Some characteristics were significantly associated with a higher risk of developing psychological distress: the presence of severe complications, the lack of autonomy, and low educational level. We did not observe any modification of the psychological picture over time. The lack of reduction in anxiety and depression over time could mean that the two pathologies are maintained by the obstacles SCI patients meet every day resulting from their neurological deficit. Our data justify the provision of psychological services for SCI patients in the rehabilitation centres; these services should still be available to the patients even after discharge.
Spinal Cord 1997 Aug
PMID:Psychological investigation of spinal cord injury patients. 926 16

The outcome in terms of health-related quality of life (HRQL) in pediatric spinal cord injury (SCI) was studied in 36 adults who had sustained an SCI in childhood. The patients were interviewed and clinically examined. HRQL was assessed with the 15D, a generic fifteen-dimensional self-administered HRQL instrument. The 15 multiple-level dimensions are moving, seeing, hearing, breathing, sleeping, eating, communicating, urinary continence, working, social participation, mental functioning, pain, depression, distress and perceived health. The respondents choose, for each dimension, the level that best describe their health status. In the 15D valuation system the respondents first assign a relative importance weight to each dimension and then a relative value to the levels on each dimension. To derive the 15D HRQL score on a 0-1 scale the level values and importance weights are multiplied and combined with the levels chosen. The average HRQL score of this SCI group was significantly lower than that measured in the population sample. The average importance weights assigned by the SCI group differed significantly (P < 0.05) from those assigned by the general population on several dimensions. The weights assigned by the SCI group were higher for the dimensions of mental functioning, communicating, social participation and seeing and lower for moving, working, sleeping and eating. These differences in valuing the dimensions of HRQL can influence behaviour and should therefore be taken into consideration in rehabilitation.
Spinal Cord 1997 Nov
PMID:Later health-related quality of life in adults who have sustained spinal cord injury in childhood. 939 45

This prospective study investigates the frequency of both medical and non-medical complications reported by the population based cohort of SCI survivors reported to the Colorado Spinal Cord Injury Early Notification System (ENS). Persons reported to the ENS between January 1 1986 and December 31 1993, representing the broad spectrum of all severities of spinal cord injury and potential complications, were solicited to participate in comprehensive follow-up interviews at their first, third and fifth year post injury. Hospitalizations of a week or longer were experienced by more than 10% of the participants at each of the three interview years. Similarly, the medical complications of spasticity or pain were reported by more than 25% of the participants, and pressure sores were reported by more than 10% at all three time periods. The chief non-medical complications (conditions) were financial concerns and transportation problems. Although these reported medical and non-medical complications present significant obstacles to be overcome, less than three percent of those surveyed at any of the time periods reported experiencing depression; and only 14% rated their quality of life as being poor.
Spinal Cord 1998 Jan
PMID:Secondary conditions following spinal cord injury in a population-based sample. 947 Nov 38

Most research into psychological aspects of spinal cord injury (SCI) has focused on adult onset. This is a retrospective study of self-perceptions following a childhood onset of SCI. Self-esteem, depression and self-perception were examined in 86 people who had a traumatic SCI before the age of 16. Depression was measured using the Beck Depression Inventory, and self-esteem using the Culture-Free Self-Esteem Inventory Self-perception was measured using a scale developed for this study, consisting of 20 adjectives, with participants themselves on dimensions of 'As I am', 'As I would be without the injury', and 'as I would be ideally'. The participants' self perceptions of the injured self and the uninjured self were found to be significantly different on only nine of the 20 adjectives. Low self-perception was found to be associated with low self-esteem and high depression levels, but independent of age at injury, level of injury and gender. The change noted by the participants between how they see themselves now and how they would have been without the injury is not as great as might have been expected.
Spinal Cord 1998 Mar
PMID:Alterations in self-perceptions following childhood onset of spinal cord injury. 955 18

Spinal cord injury is a common occurrence in Zimbabwe and carries with it a high morbidity and mortality. In the past almost all patients discharged from hospital were dead within a year. Reasons for this high mortality are presented. The establishment of the National Rehabilitation Centre has had a profound impact on the survival of these individuals as well as on improving their quality of life. The results of a retrospective survey on the mortality and life situation of individuals with spinal cord injuries sustained through trauma are presented. However major unresolved problems are inadequate housing, lack of financial support, practically no prospect of employment and depression compounded by boredom.
Spinal Cord 1998 Mar
PMID:Problems, struggles and some success with spinal cord injury in Zimbabwe. 955 24

In the last decade, a new electrophysiological tool has become available since the development of painless magnetic stimulators able to activate the primary motor cortex and the motor roots in conscious man. Therefore, it became possible to measure the conduction time within fast-conducting central motor pathways by substracting from the total latency of muscle responses elicited by cortical stimuli the conduction time in peripheral nerves. This technique proved sensitive enough to illustrate early abnormalities of central motor conduction in various neurological diseases such as multiple sclerosis, amyotrophic lateral sclerosis, cervical spondylotic myelopathy, degenerative ataxias or hereditary spastic paraplegias. When recorded early after stroke, motor evoked potentials are also a valuable tool to predict functional outcome. They can also illustrate subtle pathophysiological disturbances in diseases where there is no direct involvement of central motor pathways such as Parkinson's disease, dystonia or epilepsy. Magnetic cortical stimulation also offers unique opportunities to explore intracerebral inhibitory and excitatory circuits and mechanisms of brain plasticity. The recent development of rapid rate stimulators also enables functional studies of non-motor cerebral regions such as visual or frontal cortices. Moreover, rapid rate stimulation seems useful in the treatment of drug-resistant depression but the safety of this procedure, particularly with regard to the production of seizures or kindling, remains to be fully documented.
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PMID:[Applications of cortical magnetic stimulation]. 956 96

Sleep disordered breathing is common in patients with tetraplegia. Nocturnal arterial hypoxemia and sleep fragmentation due to sleep apnoea may be associated with cognitive dysfunction. We therefore studied the influence of sleep disordered breathing on neuropsychological function in 37 representative tetraplegic patients (mean age 34 +/- 9.7 years). Thirty percent (11 of 37 patients) had clinically significant sleep disordered breathing, defined as apnoea plus hypopnoea index (AHI) greater than 15 per hour of sleep. Most apnoeas were obstructive in type. Seven patients (19%) desaturated to < 80% during the night. Neuropsychological variables were significantly correlated with measures of sleep hypoxia, but not with the AHI and the frequency of sleep arousals. The neuropsychological functions most affected by nocturnal desaturation were: verbal attention and concentration, immediate and short-term memory, cognitive flexibility, internal scanning and working memory. There appeared to be a weak association between the presence of severe sleep hypoxia and visual perception, attention and concentration but no association was found between sleep variables and depression scores. We concluded that sleep disordered breathing is common in patients with tetraplegia and may be accompanied with significant oxygen desaturation. The latter impairs daytime cognitive function in these patients, particularly attention, concentration, memory and learning skills. Cognitive disturbances resulting from sleep apnoea might adversely affect rehabilitation in patients with tetraplegia.
Spinal Cord 1998 Apr
PMID:Sleep apnoea related hypoxia is associated with cognitive disturbances in patients with tetraplegia. 1002 2

Acute or chronic neck pain can arise from degenerative processes, musculoskeletal trauma, or structural changes. For all patients presenting with neck pain, determining the presence of radiculopathy or myelopathy is an important step in initial assessment. Depending on the duration of pain, the work-up should include appropriate use of traditional and advanced imaging studies. For cases that do not suggest traumatic, structural, or rheumatologic origins, alternate considerations should include stress, depression, and--because of its increased incidence in older persons--cancer. Nonsteroidal anti-inflammatory agents, mild oral analgesics, and short-term corticosteroid therapy are the mainstays of treatment, although physical therapy and traction can be helpful for some patients. The presence of a herniated disk, cord compression (severe stenosis), tumor, or other structural lesion may require surgical decompression.
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PMID:Neck pain. Primary care work-up of acute and chronic symptoms. 1065 73

Although, in earlier work, depression in individuals with spinal cord injury (SCI) was attributed to difficulties adjusting to SCI, more recent articles have emphasized the importance of constitutional and environmental factors not specific to SCI, as well as established theoretical models of depression. To further explore this question, 11 pairs of monozygotic twins, where one of each pair was spinal cord injured, were studied. Measures included the Beck Depression Inventory, the depression scale of the SCL-90R, and the Rosenberg Self-Esteem Scale. Using pairwise t tests, the authors did not find any significant differences between SCI and non-SCI co-twins. These findings are consistent with the idea that the occurrence of SCI does not inevitably lead to increased depression.
J Spinal Cord Med 1999
PMID:Depression and spinal cord injury: a monozygotic twin study. 1075 Nov 32

Recent evidence suggests that depression of immune function occurs early after spinal cord injury (SCI) and is maintained thereafter. Deviations from immune function observed in healthy persons with intact neuraxes include natural killer cell number and cytotoxicity, T cell function and activation, macrophage phagocytosis, levels of interleukins (IL)-2 and -6, the soluble IL-2R receptor, and intracellular adhesion molecules. While a single etiology explaining these abnormalities has not been identified, decentralization of the autonomic nervous system is the most likely cause. Otherwise, many persons with SCI, who sustain episodic autonomic overstimulation, are among the most physically deconditioned of all humans, and often select a diet rich in fat and low in protein. All of these are associated with suppressed immune function in persons without SCI. Those with SCI may also be (over)exposed to drugs and medications that suppress immune function, including methylprednisolone administered immediately after traumatic injury. No evidence suggests that the immune profiles of persons with SCI favor disease and illness resistance. As opportunistic infections of the urinary tract, lungs, and skin represent major causes of morbidity for those aging with SCI, attention to, or intervention on, immune suppressive states, traits, behaviors, diets, and medications may represent a means through which host defenses of persons with SCI can be fortified and their illness proclivities reduced.
J Spinal Cord Med 2000
PMID:Known and plausible modulators of depressed immune functions following spinal cord injuries. 1091 52


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