Epidemiology of traumatic spinal cord injury: a comparative study of anxiety or depression incidence between 2000 and 2009 and 2010-2019.

BACKGROUND: Anxiety and depression are prevalent psychological consequences following patients with traumatic spinal cord injury (tSCI). This study aims to estimate within-cohort temporal changes to compare the incidence of anxiety or depression among tSCI patients between two decades (2000-2009 and 2010-2019). METHODS: A retrospective cohort study of hospitalized tSCI patients (n = 4,960) used to compare the incidence of anxiety or depression within three years post-tSCI between the two decades. Incidence rate ratios (IRR) was estimated using Poisson regression, and Cox regression was assessed the relative risk with adjustment of age, sex, comorbidities, Charlson Comorbidity Index (CCI), and Catastrophic Illness Card status. RESULTS: The incidence rate of anxiety or depression significantly increased from 208.46 to 350.44 per 10,000 person-years (IRR = 1.68, 95% CI: 1.35-2.08, p < 0.0001). The highest increase was among patients aged 20-34 years (IRR = 1.90, 95% CI: 1.12-3.22, p = 0.0176). Adjusted Cox regression showed that tSCI patients from 2010 to 2019 had a higher risk of anxiety or depression (AHR = 1.67, 95% CI: 1.33-2.08, p < 0.0001) than those from 2000 to 2009. The risk was particularly elevated among younger patients, those without a catastrophic illness card (AHR = 1.71, p < 0.0001), and those with lower CCI scores (CCI = 0, AHR = 1.77, p = 0.0003; CCI = 1-2, AHR = 1.79, p = 0.0026). CONCLUSIONS: This study indicated an increasing anxiety or depression in tSCI patients, especially among younger adults and those without catastrophic illness status. Early psychiatric screening, multidisciplinary care, and psychosocial support are critical to improving long-term outcomes.