Person looking upset and looking out of the window.

What is the study about?

The study aimed to investigate whether grief is something that is measurably different from depression in individuals who have recently sustained a spinal cord injury (SCI).

What did the study find?

The statistical analysis of the data found that grief symptoms are measurably different from symptoms of depression after SCI and hence thought to be a distinct psychological response to injury. The study found two prevalent categories of grief symptoms - loss distress (e.g., life is unfulfilling meaningless; feeling confused, empty, part of you died; and trouble accepting SCI as real), and traumatic distress (e.g., stunned, shocked, or dazed; intrusive thoughts about SCI; and pangs of severe distress). Principal component analyses revealed a clear differentiation between grief-related loss and depression. These findings suggest that emotional distress experienced during early recovery from SCI could be addressed with treatments tailored specifically to grief and/or depression.

Who participated in the study?

The study included 206 patients who were undergoing initial rehabilitation during acute recovery from SCI. The participants were 18 years or older and fluent English speakers. Patients were excluded if they did not complete inpatient rehabilitation; had severe speech, cognitive, or psychotic disorders; or were not available by telephone after discharge.

How was the study conducted?

Trained research assistants conducted structured interviews with eligible patients, collecting data about age, sex, race, injury level, cause of injury, and time elapsed since injury. Other data collected via structured interviews included current emotional functioning (depression and grief measures), history of psychiatric disorders, and treatment with antidepressants, counseling, or psychiatric hospitalization. Participants underwent a clinical interview using a measure of Prolonged Grief Disorder (PGD) adapted specifically to reference SCI as a type of loss. This interview assessed how often and how intensely the grief symptoms were experienced. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depression.


Klyce, D.W., Bombardier, C.H., Davis, T.J., Hartoonian, N., Hoffman, J.M., Fann, J.R., & Kalpakjian, C.Z. (2015). Distinguishing grief from depression during acute recovery from spinal cord injury. Archives of Physical Medicine and Rehabilitation.

The contents of this quick review were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90DP0012-01-00). However, these contents do not necessarily represent the policy of Department of Health and Human Services, and you should not assume endorsement by the Federal Government.