Risk of depression following cervical spinal cord injury: a nationwide cohort study, 2012-2023 - 05/05/26
, Hohyun Jung 7, 8, 9, ⁎ Highlights |
• | Spinal cord injury (SCI) increases the long-term risk of developing depression. |
• | Cervical injuries show higher depression risk than lower-level injuries. |
• | Depression risk is greater in younger adults, men, and low-income groups after SCI. |
• | Early psychological screening should be part of spinal injury rehabilitation. |
• | Integrating mental health care after SCI may improve recovery and quality of life. |
Abstract |
Background |
: Spinal cord injury (SCI) causes both physical and psychological sequelae. Depression is among the most common complications, but its long-term risk according to injury level remains unclear.
Objectives |
: To evaluate the incidence and risk of depression in patients with SCI and to compare outcomes between cervical and thoracic/lumbar injuries using nationwide data.
Methods |
: We conducted a nationwide retrospective cohort study using Korean National Health Insurance and Health Screening data (2012–2023). Newly diagnosed spinal cord injury cases were identified after a 3-year washout and classified by injury level. Each was propensity-matched (1:20) with controls. Depression (single episodes and recurrent depression) risk was assessed using adjusted Cox models.
Results |
: Among 1 311 SCI patients with SCI (794 with cervical and 517 with thoracic/lumbar injuries) and 26 220 individuals without SCI, the mean follow-up was 4.1 years. Depression occurred in 11% of SCI patients and 6% of participants without SCI. The adjusted hazard ratio (aHR) for depression was 2.08 (95% confidence interval, CI, 1.57–2.75) for cervical and 1.70 (95% CI 1.16–2.50) for thoracic/lumbar injuries. Higher risks were observed in men, individuals aged < 60 years, current smokers, frequent drinkers, and low-income individuals. Kaplan–Meier analysis showed significantly lower depression-free survival among SCI patients (log-rank P < 0.001).
Conclusions |
: Cervical SCI is associated with a substantially higher risk of depression than lower-level injuries and matched controls. These findings highlight the need to integrate routine psychological screening and early mental-health intervention into SCI rehabilitation to improve emotional well-being and functional recovery.
Registration |
: Not applicable (observational study).
Le texte complet de cet article est disponible en PDF.Keywords : spinal cord injuries, depression, risk factors, cohort studies, South Korea
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