Identifying Depression Utilizing Tumor Necrosis Factor–[alpha] and Endothelial Function in Spinal Cord Injury

People with spinal cord injury (SCI) are at high risk of developing pressure injuries (PrI) and depression. Depression has been shown to be associated with increased risk for PrI complications, and it is suggested that physiological changes related to depression may contribute to PrI development. However, there is a current gap in the literature linking depression to PrI development in SCI. Study 1 was designed to investigate the association between depression symptomology, hopelessness and affect in people with SCI. Mild and moderate depression was identified with Quick Inventory of Depression Symptomology-Self Report (QIDS-SR) in some SCI participants that did not have a current depression diagnosis. SCI individuals with a complete injury, higher neurological level of injury, and a shorter duration of injury have higher depression, hopelessness and negative affect total scores compared to matched controls. Evaluating hopelessness and negative affect in addition to depression might provide a more comprehensive understanding of psychological adaptation after SCI. Study 2 aimed at investigating the association between depression symptomology, biomarker derangement of tumor necrosis factor-alpha (TNF-α), and endothelial function in people with SCI. SCI participants showed higher levels of depression, TNF-α and shorter time to reach maximum level of nitric oxide (NO)-dependent vasodilation. Although these alterations co-exist, no direct linkage among these changes was observed. Findings of these studies support further investigation of depression in the SCI population utilizing QIDS-SR supplemented with hopelessness and negative affect assessment. In addition, future studies are warranted to further investigate the pathways of how depression contributes to increased PrI risk in the SCI population.