Mental Illness and Substance Use Disorders Highly Prevalent Among Veterans with Spinal Cord Injury
Individuals with spinal cord injury (SCI) may be considered at high risk for mental illness because of the negative consequences of SCI on physical and social functioning, but the evidence is inconclusive. There also is some evidence that associates substance use disorders (SUDs) and medical complications among this population. Using VA and Medicare data, this study sought to estimate the prevalence of mental illness and SUDs among 8,338 Veterans with SCI who used outpatient or hospital care in VA or Medicare facilities between FY00 and FY01. Investigators also examined the prevalence of chronic physical conditions (e.g., diabetes, hypertension), as well as demographics.
Findings show that mental illness and SUDs are highly prevalent among Veterans with SCI. Overall, 47% of the Veterans in this study had either a mental illness or SUD. The most common mental illness was depression (27%), followed by anxiety (10%) and PTSD (6%). Tobacco use also was prevalent (19%), followed by alcohol (9%) and illicit drugs (8%). Moreover, mood and anxiety disorders were highly prevalent among those with chronic physical conditions such as diabetes, hypertension, and COPD. Results also showed that women Veterans had higher rates of mental illness and lower rates of SUD, and were significantly more likely to have mental illness only. In addition, as the duration of SCI increased, the likelihood of mental illness or SUD alone or in combination decreased. The authors recommend further studies to understand the health services use and needs of Veterans with SCI and associated mental and/or substance use disorders.
Banerjea R, Findley P, Smith B, Findley T, and Sambamoorthi U. Co-Occurring Medical and Mental Illness and Substance Use Disorders among Veteran Clinic Users with Spinal Cord Injury. Spinal Cord November 2009;47(11):789-795.
This study was funded by HSR&D. All authors except Dr. Smith are part of HSR&D's Center for Healthcare Knowledge Management for Chronic Complex Illness; Dr. Smith is part of VA/HSR&D's Spinal Cord Injury Quality Enhancement Research Initiative (SCI-QUERI).