Depression Prevalence in Spinal Cord Injury: A Meta-Analysis

Abstract

Introduction: Estimated rates of depressive disorder following a spinal cord injury (SCI) vary drastically due to measurement differences between studies and variation among individuals' personal characteristics and injuries. Objectives: To consolidate research on the point prevalence of depressive disorder among adults (≥ 16 years old) who have sustained a SCI, and to identify study and sample-level factors associated with these estimates. Methods: A review of the CINAHL, Embase, PsycINFO, and PubMed databases was conducted to identify studies that used established diagnostic criteria to determine the prevalence of depressive disorder following SCI. Risk of bias was assessed using the JBI Prevalence Critical Appraisal Tool and proportion estimates meta-analysed using a random-effects model. Moderator analyses investigated the impact of methodological characteristics and sample-related attributes on depression prevalence. Results: Pooled data with a sample of 57,300 adults with SCI from 16 independent studies indicated the prevalence of depressive disorder was 14%, although the prediction interval spanned from 1% to 73%. Prevalence estimates were similar regardless of the diagnostic criteria used (p = 101), study design (p = 549), gender (p = 583), injury type (p = 285), mean sample age (R? = .38, p = 132) or recruitment year (R? = .00, p = 265). Discussion: One in seven adults with SCI is diagnosed with a depressive disorder. This elevated prevalence cannot be solely explained by methodological or sample differences. Future research should prioritize the development of an appropriate screening tool for depression in SCI, with the aim of facilitating routine assessment for early identification and reduction of the negative consequences associated with depression, as well as provide detailed report of both study and sample attributes to increase reporting transparency and offer a thorough understanding of depression prevalence and its associated risk factors within the SCI population. Keywords: Spinal Cord Injury, Depression, Prevalence