Mental Health and Spinal Cord Injury: Clinical Considerations for Rehabilitation Providers

Objectives
To evaluate socioeconomic inequalities in social relationships, and to assess whether socioeconomic conditions and social relationships are independently related to mental health problems in individuals with a physical disability due to spinal cord injury (SCI).
Methods
We analyzed cross-sectional data from 511 individuals with SCI aged over 16 years who
participated in the community survey of the Swiss SCI Cohort Study (SwiSCI). Indicators for socioeconomic conditions included years of formal education, household income, and financial strain. Social relationships were operationalized by three structural (partner status; social contact frequency; number of supportive relationships) and four functional aspects
(satisfaction with: overall social support; family relationships; contacts to friends; partner
relationship). General mental health was assessed by the Mental Health Inventory (MHI-5)
of SF-36 and depressive symptoms were measured by the Hospital Anxiety and Depression
Scale (depression subscale, HADS-D). Established cut-offs for general mental health problems (MHI-5 56) and depressive symptomatology (HADS-D 8) were used to dichotomize outcomes. Associations were assessed using logistic regressions.