Psychological status and its association with functional outcome for paraplegic spinal cord injury

Abstract

Background: Spinal cord injury can lead to long-term physical limitations and has profound effects on psychological well-being. Depression, anxiety, and sleep disturbances are common among these individuals and may influence their functional recovery. Objectives: To assess the psychological status and examine its association with functional outcomes in individuals with paraplegic spinal cord injury. Methodology: A cross-sectional study was conducted with 92 participants diagnosed with paraplegic SCI at the Centre for the Rehabilitation of the Paralysed (CRP), Savar. Psychological status was measured using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder scale-7 (GAD-7), and Insomnia Severity Index (ISI). Functional outcomes were assessed using the Spinal Cord Independence Measure (SCIM III). Pearson’s correlation coefficients were used to determine the relationship between psychological factors and functional performance. Results: Most participants reported moderate (31.5%) to moderately severe depression (26.1%), mild (40.2%) to moderate anxiety (32.6%), and subthreshold (46.7%) to clinically significant insomnia (26.1%). Strong negative correlations were found between psychological status and SCIM III total score (r = -0.609, p < 0.05), anxiety (r = -0.556, p < 0.05), and sleep quality (r = -0.372, p < 0.05). That means, if depression, anxiety, and poor sleep quality increase the functional outcome of participants will be decreased significantly. Depression and anxiety were found to be the most profound issues, and among SCIM domains, mobility showed the strongest inverse correlations with psychological factors. Discussion: The study reveals a significant association between psychological health and functional outcomes in paraplegic SCI patients. Higher levels of depression, anxiety, and poor sleep quality are linked to lower functional outcomes, especially in mobility and self-care as well as respiration and sphincter management. These findings highlight the need of holistic patient care, and integrated psychological support in rehabilitation programs to improve overall outcomes in SCI patients.

Keywords: Paraplegic SCI, depression, anxiety, sleep quality, functional outcome, SCIM III.