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Neurological Rehabilitation

Impact of Depression During Inpatient Rehabilitation on Health, Participation, and Satisfaction with Life at One-Year Post-Injury for Persons with Spinal Cord Injury

Saturday, October 25, 2025
12:00 PM - 1:30 PM MT
Location: Original Research Theater
Has Audio
Disclosure(s):
Drew Redepenning, MD: No financial relationships to disclose
Lynn Worobey, PhD, Other: No financial relationships to disclose
Background and/or Objectives: To determine the impact of depression during inpatient rehabilitation on health, participation, and satisfaction with life at one-year post-injury in persons with spinal cord injury (SCI).

Design: Prospective cohort study.

Setting : SCI Model Systems.

Participants : Individuals (N=3,298) older than 18 years of age enrolled in a SCI Model Systems Center between 2016 to 2024 who had complete data for the Patient Health Questionnaire – 9 (PHQ-9) at the time of inpatient rehabilitation and had completed the one-year follow-up interview.

Interventions: Not applicable.

Main Outcome Measures: Urinary tract infections, pressure injury, rehospitalizations, days hospitalized, pain severity, self-perceived health status (SPHS), cumulative Craig Handicap and Reporting Technique (CHART) score, and Satisfaction with Life Scale (SWLS) score at the one-year follow-up.

Results: Two separate criteria were used to determine the presence of depression during inpatient rehabilitation using the PHQ-9 score; 340 (10.3%) and 124 (3.8%) participants met criteria for depression, respectively. Those meeting either criteria for depression (vs. no depression) were more likely to report ≥1 rehospitalizations (odds ratio [OR]: 2.2; OR: 2.6), hospitalization ≥14 days (OR: 1.5; OR: 2.2), a higher pain severity (OR:1.6; OR: 1.9), a lower SPHS (OR: 1.9; OR: 2.9), lower cumulative CHART scores (-21.9; -34.7), and a lower SWLS score (OR: 2.3; OR: 2.7) at the one-year follow-up. Increased likelihood of pressure injury (OR: 2.2) was found only when using the stricter criterion for depression.

Conclusions: Results from this study demonstrate the possible detrimental impact of depression during inpatient rehabilitation on post-discharge outcomes in persons with SCI. Future research should investigate whether this can be mitigated by early initiation of treatment in the inpatient setting. The PHQ-9 appears to be a good marker for identification of individuals at risk for poorer outcomes after discharge and should be used to screen for those who need intervention for depressive symptoms during inpatient rehabilitation.