Anxiety and Depression in Pediatric-Onset Traumatic Spinal Cord Injury: A Systematic Review

BACKGROUND:AND PURPOSE: Traumatic spinal cord injury (TSCI) is a debilitating neurological condition with significant long-term consequences on the mental health and wellbeing of affected individuals. We aimed to investigate anxiety and depression in individuals with pediatric-onset TSCI. MATERIALS AND METHODS:PubMed, Scopus, and Web of Science databases were searched from inception to December 20th, 2022 following the PRISMA guidelines and studies were included according to the eligibility criteria. RESULTS:1,013 articles were screened, and 18 studies with 4,234 individuals were included in the final review. 1,613 individuals (38.1%) had paraplegia, whereas 1658 (39.2%) had tetraplegia. 1,831 participants (43.2%) had complete TSCI, whereas 1024 (24.2%) had incomplete TSCI. The most common etiology of TSCI with 1,545 people (36.5%) was motor vehicle accidents. The youngest mean age at the time of injury was 5.92 ± 4.92 years, whereas the oldest was 14.6 ± 2.8 years. Patient Health Questionnaire-9 was the most common psychological assessment used in 9 studies (50.0%). Various risk factors, including pain in 4 studies (22.2%), reduced sleep quality, reduced functional independence, illicit drug use, incomplete injury, hospitalization, reduced quality of life, and duration of injury in 2 (11.1%) studies, each, were associated with elevated anxiety and depression. CONCLUSIONS:Different biopsychosocial risk factors contribute to elevated rates of anxiety and depression among individuals with pediatric-onset TSCI. Individuals at risk of developing anxiety and depression should be identified, and targeted support should be provided. Future large-scale studies with long-term follow-up are required to validate and extend these findings.