Relationships Between Functionality, Depression and Anxiety with Community Integration and Quality of Life in Chronic Traumatic Spinal Cord Injury.

OBJECTIVES i) identifying relationships between functional and psychological aspects with community integration and quality of life (QoL) assessments in people with chronic traumatic spinal cord injury (TSCI) ii) analyzing clinical and demographic predictors of QoL dimensions. DESIGN Observational cohort study, correlation coefficients were calculated between the Functional Independence Measure (FIM), the Hospital Anxiety and Depression Scale (HADS), the Community Integration Questionnaire (CIQ) and the WHOQOL-BREF dimensions (Physical (D1), Psychological (D2), Social (D3) and Environmental (D4)). QoL predictors were identified using multiple linear regression analyses. RESULTS 975 people with TSCI assessed since 2007 to 2020 were included. CIQ home integration correlated strongly with FIM self-care (r=0.74) and transfers (r=0.62) for participants with tetraplegia. Specific HADS items (known as the anhedonia subscale) correlated strongly with D1 (r=-0.65), D2 (r=-0.69), D3 (r=-0.53) and D4 (r=-0.51) for participants with paraplegia and D1 (r=-0.53), D2 (r=-0.61), D3(r=-0.47) and D4(r=-0.53) for participants with tetraplegia. HADS Depression was the most relevant predictor of D1 (β = -0.61 and D2(β = -0.76). CONCLUSIONS FIM transfers and self-care were strongly associated to CIQ home integration (in participants with tetraplegia). Anhedonia was strongly related to all 4 WHOQOL-BREF dimensions, being HADS depression the most relevant predictor of D1 and D2.