Adults living with spinal cord injuries have a nearly 80 percent increased risk of developing psychological conditions, such as depression and anxiety, compared to people without traumatic injuries, a new study shows. But chronic pain can have an equally large negative effect on mental health.
The study is published in Spinal cord by a Michigan Medicine-led team of researchers who analyzed the private insurance claims of more than 9,000 adults with a traumatic spinal cord injury and more than 1 million adults without. They accounted for a range of psychological conditions, from anxiety and mood disorders to insomnia and dementia.
people living with a spinal cord injury were diagnosed with a mental health condition more often than those without the lesion: 59.1% vs. 30.9%. While depression and adverse mental health effects are not inevitable consequences of all traumatic spinal cord injuries, previous findings have consistently echoed higher levels of psychological morbidity in this group than in the general population without spinal cord injuries.
In this study, however, chronic centralized and neuropathic pain among adults living with spinal cord injury was found to be strongly associated with post-traumatic stress disorder, substance use disorders, and other mental health conditions. . In most cases, chronic pain was a even bigger influence on these conditions than exposure to living with the injury itself.
The researchers say the findings should prompt clinicians to identify mental health conditions when caring for spinal cord injury patients and refer them to mental health providers for treatment.
“Better clinical efforts are needed to facilitate early detection and treatment of both chronic pain and psychological health in this higher-risk population,” he said. Mark Peterson, Ph.D.The paper’s lead author and an associate professor of physical medicine and rehabilitation at Michigan Medicine.
However, the researchers note that a lack of insurance coverage and limited available services will likely leave the problem largely unaddressed.
“Stakeholders should work together to lobby for more federal funding for research and special policy amendments to ensure adequate, long-term physical and mental health insurance coverage to meet the needs of people living with spinal cord injuries,” Peterson said.
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Other authors include Michelle Meade, Ph.D., Michigan Medicine Department of Physical Medicine and Rehabilitation, Paul Lin, MS, University of Michigan Institute for Health Care Policy and Innovation, Neil Kamdar, MA, Health Care Policy Institute Healthcare and Innovation, Gianna Rodriguez, MD, Michigan Department of Physical Medicine and Rehabilitation, Elham Mahmoudi, Ph.D., Michigan Department of Family Medicine, and James Krause, Ph.D, Medical University of South Carolina.
This research was carried out in part thanks to a grant from the National Institute of Disability, Independent Living, and Rehabilitation Research (NIDILRR #90RTHF0001-01-00).
Article cited: “Psychological morbidity after spinal cord injury and among those without spinal cord injury: the impact of chronic centralized and neuropathic pain”. Spinal cord. DOI: 10.1038/s41393-021-00731-4
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