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Trajectories and predictors of the course of mental health after spinal cord injury.
MedLine Citation:
PMID:  22835856     Owner:  NLM     Status:  Publisher    
OBJECTIVE: To study the course and predictors of mental health in the period between the start of active spinal cord injury (SCI) rehabilitation and 5 years after discharge. The hypothesis was that different mental health trajectories can be identified. DESIGN: Multi-centre prospective cohort study with measurements at the start of active rehabilitation, after 3 months, at discharge, 1, 2, and 5 years after discharge. SETTING: Eight Dutch rehabilitation centres with specialised SCI units. PARTICIPANTS: Persons (n=206) with recently acquired SCI and age between 18 and 65 years. INTERVENTIONS: Not applicable MAIN OUTCOME: The five-item Mental Health Index (MHI-5) with a total score between 0 (lowest mental health) and 100 (highest mental health). RESULTS: Levels of mental health increased between the start of active rehabilitation and three months later, remained stable thereafter, and increased again between 2 and 5 years after discharge. Latent Class Growth Mixture Modelling revealed 5 trajectories: (a) high scores (above 80) at all time-points (52%), (b) low scores (60 or below) at all time-points (4%), (c) early recovery from 40 to scores above 70 (13%), (d) intermediate scores from 60 to scores above 70 (29%), and (e) severe deterioration of scores above 70 to scores below 30 (2%). Pain, sex, and educational level were predictors to distinguish between the five trajectories. CONCLUSIONS: Five different mental health trajectories were identified between the start of active rehabilitation and 5 years after discharge. About a third of the persons with SCI still perceived moderate to severe mental health problems 5 years after discharge. Pain, sex, and educational level only predicted a small part of the variance in mental health trajectories.
Christel M C van Leeuwen; Trynke Hoekstra; Casper F van Koppenhagen; Sonja de Groot; Marcel W M Post
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-23
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  -     ISSN:  1532-821X     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 the American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
Swiss Paraplegic Research, Nottwil, Switzerland; Rudolf Magnus Institute of Neuroscience and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands.
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