Prevalence of Major Depressive Disorder in Patients Following Spine Trauma

Amber  Abbas; M. Imran  Jan; Farhad  Ali; Ramesh  Kumar; Zulqarnain  Anis; Sameer  Khulsai

doi:10.54112/bcsrj.v6i6.1930

Authors

Amber Abbas Department of Neurosurgery, Civil Hospital, Karachi, Dow University of Health Sciences, Karachi. Pakistan
M. Imran Jan Department of Neurosurgery, Civil Hospital, Karachi, Dow University of Health Sciences, Karachi. Pakistan
Farhad Ali Department of Neurosurgery, Civil Hospital, Karachi, Dow University of Health Sciences, Karachi. Pakistan
Ramesh Kumar Department of Neurosurgery, Civil Hospital, Karachi, Dow University of Health Sciences, Karachi. Pakistan
Zulqarnain Anis Department of Neurosurgery, Civil Hospital, Karachi, Dow University of Health Sciences, Karachi. Pakistan
Sameer Khulsai Department of Neurosurgery, Civil Hospital, Karachi, Dow University of Health Sciences, Karachi. Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i6.1930

Keywords:

Spinal Injuries, Depressive Disorder, Major Prevalence Risk Factors, Cross-Sectional Studies

Abstract

Spinal trauma carries a high risk of psychological sequelae, yet Pakistani data are scarce. Objectives: To measure the prevalence of probable Major Depressive Disorder (MDD) ≥6 weeks after injury and explore associated factors. Methods: A descriptive cross‑sectional study was conducted in the spine outpatient department of SMBBIT, Karachi, from August 2024 to January 2025. The institutional review board approved the protocol, and written informed consent was obtained from all participants prior to their participation. Consecutive sampling was used. Inclusion criteria were: adults aged 18–65 years; documented vertebral fracture or dislocation confirmed on imaging; presentation ≥6 weeks after injury; and ability to understand Urdu. Exclusion criteria comprised congenital spinal deformity, tumour, prior spine surgery, active psychosis, previous psychiatric diagnosis, or use of antidepressants before trauma. A PHQ-9 score≥10 indicated MDD; Wilson confidence intervals and bivariate tests summarized the results. Results: MDD prevalence was 42.6 % (95 % CI 34.9–50.6); female sex and comorbidity were significant correlates. Conclusions: One‑third of survivors screened positive, underscoring the need for integrated mental‑health Care.

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References

Craig A, Tran Y, Middleton J. Psychological morbidity and spinal cord injury: a systematic review. Spinal Cord. 2009;47(2):108-14. https://doi.org/10.1038/sc.2008.115

Bombardier CH, et al. Rates of major depressive disorder and clinical features in individuals with spinal cord injury. Arch Phys Med Rehabil. 2016;97(1):138-45.

Furlan JC, Fehlings MG. Depression in patients with spinal cord injury: outcomes and management. Spinal Cord. 2009;47(10):786-92.

Turner BJ, et al. Suicide in spinal cord injury: a retrospective cohort study. Arch Phys Med Rehabil. 2017;98(6):1137-44.

Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW, et al. Health care utilization following spinal cord injury: a population-based study. Spinal Cord. 2004;42(9):511-8. https://doi.org/10.1038/sj.sc.3101629

Khan MR, et al. Epidemiology of spine injuries at a tertiary trauma center in Pakistan. J Pak Med Assoc. 2022;72(3):525-31.

Kroenke K, Spitzer RL. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Khan M, et al. Establishment and evaluation of Pakistan’s trauma registry: insights from a public sector institute. BMC Emerg Med. 2020;20:42.

Williams R, et al. Depression among persons with spinal cord injury, 1998–2003. Arch Phys Med Rehabil. 2004;85(11):1741-8.

Gadit AAM, et al. Depression in Pakistan: point prevalence and gender differences. J Pak Med Assoc. 2016;66(9):1072-5.

Hammond FM, et al. Gender differences in depression after spinal cord injury. Arch Phys Med Rehabil. 2014;95(5):885-93.

Pan A, Sun Q, Okereke OI, Rexrode KM, Hu FB. Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA. 2011;306(11):1241-9. https://doi.org/10.1001/jama.2011.1282

Caine R, et al. Cognitive behavioural therapy for depression in spinal cord injury: a systematic review. Spinal Cord. 2021;59(8):873-902.