Modeling Long-Term Depression Trajectories After Spinal Cord Injury Using Irregularly Sampled Assessments and Rehabilitation Baseline Predictors.
Purpose: To identify and characterize latent trajectories of depression using growth mixture modeling (GMM) applied to irregularly timed assessments spanning up to 20 years post-injury, examine baseline rehabilitation variables significantly associated with trajectory membership, and determine predi...
| Publicado en: | NeuroRehabilitation Vol. 58; no. 3; pp. 486 - 500 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
May2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=193319996&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 193319996 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10538135 3RE jtl: NeuroRehabilitation issn: 10538135 maglogo: N pubinfo: dt: May2026 vid: 58 iid: 3 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 193319996 192679672 193319996 193319996 10.1177/10538135261433166 193319996 ppf: 486 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Modeling Long-Term Depression Trajectories After Spinal Cord Injury Using Irregularly Sampled Assessments and Rehabilitation Baseline Predictors. aug: au: García-Rudolph, Alejandro Soler, Maria Dolors Gilabert, Anna Opisso, Eloy Saurí, Joan affil: Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain sug: subj: Spinal Cord Injuries Psychosocial Factors Spinal Cord Injuries Rehabilitation Spinal Cord Injuries Complications Depression Symptoms Depression Diagnosis Time Human Spain Male Female Adult Middle Age Retrospective Design Nonexperimental Studies Rehabilitation Centers Logistic Regression ROC Curve Inpatients Descriptive Statistics Inferential Statistics Chi Square Test T-Tests One-Way Analysis of Variance Mann-Whitney U Test Kruskal-Wallis Test Post Hoc Analysis Scales Confidence Intervals Delayed Onset Support, Psychosocial Risk Assessment Structural Equation Modeling Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Purpose: To identify and characterize latent trajectories of depression using growth mixture modeling (GMM) applied to irregularly timed assessments spanning up to 20 years post-injury, examine baseline rehabilitation variables significantly associated with trajectory membership, and determine predictors of sustained depressive burden. Methods: This retrospective observational cohort study included adults with traumatic or non-traumatic spinal cord injury admitted for inpatient rehabilitation within 3 months post-injury (2005–2023), with follow-up extending until May 2025. Depressive symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS-D) at admission, discharge, and follow-up, totaling 3,258 assessments (n = 679 patients). GMM identified latent trajectories while accommodating irregularly spaced assessments. Predictors of trajectory membership were analyzed through multivariable regression with quantified model discrimination. Results: A 3-class GMM solution provided optimal fit (entropy=0.75). Most participants (81.6%) followed a stable low-depression trajectory (Class 1). A borderline depression trajectory (Class 2; 8.4%) remained persistently elevated, while a probable depression trajectory (Class 3; 10.0%) displayed delayed worsening peaking at 5–7 years post-injury. Class 3 included a significantly higher proportion of non-traumatic injuries (63%) and females (44.1%), with most patients (85.3%) showing no depressive symptoms during rehabilitation, but later exhibiting a marked increase in depressive burden. Logistic regression predicting Class 2 achieved good discrimination (AUC=0.81; 95% CI, 0.65–0.97), identifying baseline depressive symptoms, tetraplegia, female sex, and primary level of education as significant predictors. Conclusions: Irregularly sampled follow-ups revealed distinct depression trajectories, including delayed-onset risk. Findings emphasize early rehabilitation-based screening and long-term monitoring to target follow-up and psychological support. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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