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December 1981, Vol 38, No. 12 >
Article | December 1981

Psychiatric Disorders in Patients With Spinal Cord Injuries

Donald T. Fullerton, MD; Richard F. Harvey, MD; Marjorie H. Klein, PhD; Timothy Howell, MD
[+] Author Affiliations

Accepted for publication July 1, 1981.

Reprint requests to Department of Psychiatry, University of Wisconsin Medical School, 600 Highland Ave, Madison, WI 53792 (Dr Fullerton).


Arch Gen Psychiatry. 1981;38(12):1369-1371. doi:10.1001/archpsyc.1981.01780370071010
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• Although previous studies have reported that all patients with spinal cord injuries experience depression, they have not distinguished between despondency and depressive disorder. Of 30 patients with spinal cord lesions and depressive disorders diagnosed using the Schedule for Affective Disorders and Schizophrenia and the Research Diagnostic Criteria (RDC), 15 patients had RDC diagnoses before or after their injury. A depressive disorder developed in nine after injury. Eight depressive disorders developed within a month of the injury. Postinjury depressive disorders were more common in patients with complete spinal cord lesions but were divided equally between paraplegics and quadriplegics. Only one patient received antidepressants. The remainder recovered without treatment other than the rehabilitation program. The accident causing the injury seemed related to a psychiatric disorder before injury in six patients (four alcoholics and two hypomanics) and to drinking before the accident in 15 patients.

REFERENCES

1 +
Lloyd C:  Life events and depressive disorder reviewed: II. Events as precipitating factors . Arch Gen Psychiatry 1980;;37:541-548.
2 +
Radloff LS:  Risk factors for depression , in Guttentag M, Salasin S, Belle D (eds): The Mental Health of Women . New York, Academic Press Inc, 1980;, chap 5.
3 +
Bracken MB, Shepard MJ:  Coping and adaption following acute spinal cord injury: A theoretical analysis . Paraplegia 1980;;18:74-85.
4 +
Stewart TD:  Spinal cord injury: A role for the psychiatrist . Am J Psychiatry 1977;;134:538-541.
5 +
Wittkower ED, Gingras G, Mergler L, et al:  A combined psychosocial study of spinal cord lesions . Can Med Assoc J 1954;;71:109-115.
6 +
Hohmann G:  Psychological aspects of treatment and rehabilitation of the spinal cord injured person . Clin Orthop 1975;;112:81-88.
7 +
Stewart TD:  Coping behavior and the moratorium following spinal cord injury . Paraplegia 1977;;15:338-342.
8 +
Siller J:  Psychological situation of the disabled with spinal cord injuries . Rehabil Lit 1969;;30:290-296.
9 +
Cook DW:  Psychological aspects of spinal cord injury . Rehabil Counsel Bull 1976;;19:535-543.
10 +
Trieschmann RB: Spinal Cord Injuries: Psychological, Social and Vocational Adjustment . New York, Pergamon Press, 1980;.
11 +
Howell T, Fullerton DT, Harvey RF, et al:  Depression in spinal cord injured patients . Paraplegia 1981;;19:204-208.
12 +
Spitzer RL, Endicott J: Schedule for Affective Disorders and Schizophrenia, Lifetime Version and Change Version , ed 3. New York, Biometrics Research Division, New York State Psychiatric Institute, 1978;.
13 +
Endicott J, Spitzer RL:  A diagnostic interview: The schedule for affective disorders and schizophrenia . Arch Gen Psychiatry 1978;;35:837-844.
14 +
Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria for a Selected Group of Functional Disorders , ed 3. New York, Biometrics Research Division, New York State Psychiatric Institute, 1978;.
15 +
Spitzer RL, Endicott J, Robins E:  Research Diagnostic Criteria: Rationale and reliability . Arch Gen Psychiatry 1978;;35:773-782.
16 +
Weismann MM, Myers JR, Harding PS:  Psychiatric disorders in a US urban community: 1975-1976 . Am J Psychiatry 1978;;135:459-462.
17 +
Folstein MF, Maiberger R, McHugh RP:  Mood disorder as a specific complication of stroke . J Neurol Neurosurg Psychiatry 1977;;40:1018-1020.
18 +
Wing JK, Cooper JE, Sartorius N: The Measurement and Classification of Psychiatric Symptomatology . Cambridge, England, Cambridge University Press, 1974;.
19 +
Dorfman W:  Depression: Its expansion in physical illness . Psychosomatics 1978;;19:702-708.
20 +
Levy NB:  Psychological problems of the patient on hemodialysis . Psychother Psychosom 1978;;31:260-266.
21 +
Levy NB:  The chronically ill patients . Psychiatric Q 1979;;51:189-197.
22 +
Cassem NH:  Depression , in Hackett TP, Cassem NH (eds): Handbook of General Hospital Psychiatry . St Louis, CV Mosby Co, 1978;, chap 10.
23 +
Noyes R, Kletti R:  Depersonalization in the face of life-threatening danger: A description . Psychiatry 1976;;39:19-27.
24 +
Noyes R, Hoenk PR, Kuperman S, et al:  Depersonalization in accident victims and psychiatric patients . J Nerv Ment Dis 1977;;164:401-407.
25 +
Noyes R, Kletti R:  Depersonalization in response to life-threatening danger . Comp Psychiatry 1977;;18:375-384.
26 +
Noyes R, Frye SJ, Slymen DJ, et al:  Stressful life events and burn injuries . J Trauma 1979;;19:141-144.

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1 +
Lloyd C:  Life events and depressive disorder reviewed: II. Events as precipitating factors . Arch Gen Psychiatry 1980;;37:541-548.
2 +
Radloff LS:  Risk factors for depression , in Guttentag M, Salasin S, Belle D (eds): The Mental Health of Women . New York, Academic Press Inc, 1980;, chap 5.
3 +
Bracken MB, Shepard MJ:  Coping and adaption following acute spinal cord injury: A theoretical analysis . Paraplegia 1980;;18:74-85.
4 +
Stewart TD:  Spinal cord injury: A role for the psychiatrist . Am J Psychiatry 1977;;134:538-541.
5 +
Wittkower ED, Gingras G, Mergler L, et al:  A combined psychosocial study of spinal cord lesions . Can Med Assoc J 1954;;71:109-115.
6 +
Hohmann G:  Psychological aspects of treatment and rehabilitation of the spinal cord injured person . Clin Orthop 1975;;112:81-88.
7 +
Stewart TD:  Coping behavior and the moratorium following spinal cord injury . Paraplegia 1977;;15:338-342.
8 +
Siller J:  Psychological situation of the disabled with spinal cord injuries . Rehabil Lit 1969;;30:290-296.
9 +
Cook DW:  Psychological aspects of spinal cord injury . Rehabil Counsel Bull 1976;;19:535-543.
10 +
Trieschmann RB: Spinal Cord Injuries: Psychological, Social and Vocational Adjustment . New York, Pergamon Press, 1980;.
11 +
Howell T, Fullerton DT, Harvey RF, et al:  Depression in spinal cord injured patients . Paraplegia 1981;;19:204-208.
12 +
Spitzer RL, Endicott J: Schedule for Affective Disorders and Schizophrenia, Lifetime Version and Change Version , ed 3. New York, Biometrics Research Division, New York State Psychiatric Institute, 1978;.
13 +
Endicott J, Spitzer RL:  A diagnostic interview: The schedule for affective disorders and schizophrenia . Arch Gen Psychiatry 1978;;35:837-844.
14 +
Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria for a Selected Group of Functional Disorders , ed 3. New York, Biometrics Research Division, New York State Psychiatric Institute, 1978;.
15 +
Spitzer RL, Endicott J, Robins E:  Research Diagnostic Criteria: Rationale and reliability . Arch Gen Psychiatry 1978;;35:773-782.
16 +
Weismann MM, Myers JR, Harding PS:  Psychiatric disorders in a US urban community: 1975-1976 . Am J Psychiatry 1978;;135:459-462.
17 +
Folstein MF, Maiberger R, McHugh RP:  Mood disorder as a specific complication of stroke . J Neurol Neurosurg Psychiatry 1977;;40:1018-1020.
18 +
Wing JK, Cooper JE, Sartorius N: The Measurement and Classification of Psychiatric Symptomatology . Cambridge, England, Cambridge University Press, 1974;.
19 +
Dorfman W:  Depression: Its expansion in physical illness . Psychosomatics 1978;;19:702-708.
20 +
Levy NB:  Psychological problems of the patient on hemodialysis . Psychother Psychosom 1978;;31:260-266.
21 +
Levy NB:  The chronically ill patients . Psychiatric Q 1979;;51:189-197.
22 +
Cassem NH:  Depression , in Hackett TP, Cassem NH (eds): Handbook of General Hospital Psychiatry . St Louis, CV Mosby Co, 1978;, chap 10.
23 +
Noyes R, Kletti R:  Depersonalization in the face of life-threatening danger: A description . Psychiatry 1976;;39:19-27.
24 +
Noyes R, Hoenk PR, Kuperman S, et al:  Depersonalization in accident victims and psychiatric patients . J Nerv Ment Dis 1977;;164:401-407.
25 +
Noyes R, Kletti R:  Depersonalization in response to life-threatening danger . Comp Psychiatry 1977;;18:375-384.
26 +
Noyes R, Frye SJ, Slymen DJ, et al:  Stressful life events and burn injuries . J Trauma 1979;;19:141-144.

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