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Titre : | An Exploration of Modifiable Risk Factors for Depression After Spinal Cord Injury: Which Factors Should We Target? (2012) |
Auteurs : | Charles Bombardier ; Jesse Fann ; Denise G. Tate ; et al. |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2012/5, 2012) |
Article en page(s) : | pp. 775-781 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Dépression ; Facteurs de risque ; Rééducation et réadaptation ; Traumatismes de la moelle épinière |
Mots-clés: | Risk factors ; Spinal cord injuries |
Résumé : |
Objective To identify modifiable risk factors for depression in people with spinal cord injury (SCI). Design Cross-sectional survey. Setting Outpatient and community settings. Participants Community-residing people with SCI (N=244; 77% men, 61% white; mean age, 43.1y; 43% with tetraplegia) who were at least 1 month postinjury. Interventions Not applicable. Main Outcome Measures Depression severity (Patient Health Questionnaire-9 [PHQ-9]), physical activity (International Physical Activity Questionnaire [IPAQ]), pleasant and rewarding activities (Environment Rewards Observation Scale [EROS]), and self-efficacy to manage the effects of SCI (Modified Lorig Chronic Disease Self-Management Scale). Results Greater depression severity was associated with being 20 to 29 years of age, not completing high school, not working or attending school, and being ≤4 years post-SCI. After controlling for demographic and injury characteristics (adjusted R2=.13), lower EROS scores (change in adjusted R2=.34) and lower self-efficacy (change in R2=.13) were independent predictors of higher PHQ-9 scores. Contrary to predictions, physical activity as measured by the IPAQ did not predict depression severity. Conclusions Our findings suggest that having fewer rewarding activities, and to a lesser extent, having less confidence in one's ability to manage the effects of SCI are independent predictors of greater depression severity after SCI. Interventions such as behavior activation, designed to increase rewarding activities, may represent an especially promising approach to treating depression in this population. |
Disponible en ligne : | Oui |
En ligne : | http://www.archives-pmr.org/article/S0003-9993%2812%2900010-X/abstract |