Depression or anxiety symptoms associated with occupational role transitions in Brazilian adults with a traumatic spinal cord injury: A multivariate analysis

Abstract

BACKGROUND: Psychological morbidity is commonly experienced by people with a spinal cord injury (SCI), but whether it is associated with occupational role transitions in is unknown. OBJECTIVE: To analyze whether anxiety or depression symptoms are independently associated to increased likelihoods of role transitions in adults with SCI. METHODS: Cross-sectional study; multivariate analysis using a heteroscedastic Dirichlet regression. Participants: Thirty persons with traumatic SCI. Measures: Role Checklist (e.g. role transitions: dependent variables) and Beck’s Depression Inventory and State-Trait Anxiety Inventory (independent variables), adjusted for socio-demographic, functional, and injury-level confounders. RESULTS: Greater depression symptoms independently increased the likelihood of occupational role transitions, either for roles loss [adjusted Odds Ratio (AOR): 1.04; 95% confidence interval (CI):1.009–1.080] or roles gain [AOR: 1.07; 95% CI:1.02–1.13], as opposed to continued occupational roles. Higher anxiety as a trait, in turn, independently reduced the likelihood of occupational roles gain [AOR: 0.93; 95% CI: 0.869–0.992]. The “worker” role was the one lost more frequently (83%). CONCLUSION: Psychological morbidity is associated to occupational role transitions, as opposed to continued roles. Further research (e.g. with larger samples, longitudinal design, using structural equation modelling) should elucidate on the intricate relationships between mental health status and occupational role transitions in people experiencing SCI.