Depression in patients with spinal injury in Qatar: a mixed-methods study

Abstract

Background: There is a high prevalence of depression in people with spinal injury. It has a major negative influence on health and performance of daily living activities following the injury. Social support plays an important role in the recovery process of patients. Objectives: The objectives of the study were to determine the prevalence of depression; identify the association between the level of depression and the cause and site of spinal injury, sociodemographic factors, and social support; and explore the experiences of depression in patients with spinal injury in Qatar. Methods: A cross-sectional mixed-methods study was conducted. All patients admitted to Hamad Medical Corporation in 2020 with spinal injury were surveyed using an interviewer-administered questionnaire in Arabic, English or Hindi. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). The Social Support Survey was used to assess overall social support and four specific aspects of social support. Demographic data were collected. The cause and site of injury were obtained from patient records. Semi-structured interviews were conducted with purposively selected participants. Results: A total of 106 participants participated in the survey. In-depth interviews were conducted with 12 participants. For the survey component, the average age of participants was 35.82±10.00 years, the majority were males (94.3%), and 69% had some level of depression (mild: 28%, minimal: 25.5%, and moderate to severe: 15%). Depression was not associated with socio-demographic factors or the cause or site of spinal injury. Emotional/informational support and positive social interaction were inversely correlated with depression scores. The interviews revealed that spinal injury had a negative impact on participants’ daily lives and their physical, mental, social, and spiritual wellbeing. Emotional/informational support and positive social interaction were both inversely correlated with depression. This was consistent with the findings of the interviews, which highlighted the important role of social support in improving participants’ ability to cope with their new situation. Conclusion: Depression is prevalent among patients with spinal injury. Early detection, referral, and treatment of depression are recommended. Strategies to enhance emotional/informational support and positive social interaction should be developed and tested in patients with spinal injury.