Depression, pain intensity, and interference in acute spinal cord injury

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Study investigated the independent contributions of pain intensity and pain interference to depression in individuals undergoing acute inpatient rehabilitation for traumatic spinal cord injury (SCI). Participants completed a survey that included measures of depression, pain intensity, and pain interference (in the domains of general activity, mood, mobility, relations with others, sleep, and enjoyment of life). Demographic and injury characteristics and information about current use of antidepressants and pre-injury binge drinking also were collected. Hierarchical multiple regression was used to test depression models in 3 steps: (1) age, gender, days since injury, injury level, antidepressant use, and pre-injury binge drinking (controlling variables); (2) pain intensity; and (3) pain interference (each tested separately). With one exception, pain interference was the only statistically significant independent variable in each of the final models. Although pain intensity accounted for only 0.2 to 1.2 percent of the depression variance, pain interference accounted for 13 to 26 percent of the variance in depression. The findings suggest that pain intensity alone is insufficient for understanding the relationship of pain and depression in acute SCI. Instead, the ways in which pain interferes with daily life appear to have a much greater bearing on depression.

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