Risk factors associated with newly psychiatric disorder in spinal cord injury: A retrospective cohort study

Aim and objectives: To predict the risk factors related to newly diagnosed psychiatric disorders resulting from spinal cord injuries (SCIs). Background: SCIs are a common result of devastating accidents; they can have an essential negative impact on the psychological health of those so afflicted. Psychiatric disorders commonly occur worldwide and are often associated with pain and disability; however, few studies have investigated the risk factors of psychiatric disorders among persons with SCIs. Design: A retrospective cohort study design with data obtained from the Taiwan Health Insurance Research Database (THIRD). THIRD involves the claims data on recipients recorded in the Taiwan National Health Insurance (TNHI), which was set up in 1995 and covers about 99% of the 23 million persons in Taiwan. Methods: We used THIRD to predict the risk factors related to newly diagnosed psychiatric disorders among victims of spinal cord injury. Results: The majority of persons with SCI were men (51.2%), and their average age was 52.8 years. All 5,828 newly diagnosed psychiatric disorders were included from 1997–2009 in 64,907 SCI in the THIRD data set. These results demonstrated notable differences in hazard risk (HR); the injured persons were inspected for the level of SCI, age, hypertension and chronic obstructive pulmonary disease (HR: 1.637, 95% CI: 1.452–1.844, p <.0001; HR: 1.005, 95% CI: 1.002–1.009, p =.0019; HR: 0.724, 95% CI: 0.642–0.816; HR: 1.267, 95% CI: 1.105–1.454, p =.0007; HR: 1.368, 95% CI: 1.183–1.582, p <.0001, respectively); the persons with SCI exhibited significant independent associations with psychiatric disorders. Conclusions: The results revealed that the level of SCI, female gender and age, respectively, affects the incidence of newly diagnosed psychiatric disorder related to SCI. Relevance to clinical practice: This study showed that psychiatric disorders may be associated with the development of SCI, and that this risk was more predominant in females with SCI. Our results are of direct clinical relevance as they are meant to assist clinical assessment, counselling, guidance of symptomatic monitoring and early clinical intervention.