Depressive symptom trajectories after spinal cord injury: a secondary analysis of public-use data.

Cohort studyAnnals of physical and rehabilitation medicine· Aug 2026

Depressive symptom trajectories after spinal cord injury: a secondary analysis of public-use data.

Andrea Calderone, Rosaria De Luca, Rosalia Calapai … Rocco Salvatore Calabrò

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Spinal Cord Injury RehabilitationCohort studyPrognosisQ1IF 3.5

Persistent elevated depressive symptoms linked to highest 10-year rehospitalization risk after spinal cord injury

Depressive symptom trajectories after spinal cord injury: a secondary analysis of public-use data.

Andrea Calderone … Rocco Salvatore Calabrò

Annals of physical and rehabilitation medicine · Aug 2026 · Q1 in Rehabilitation

Background

Depressive symptoms after spinal cord injury (spinal cord injury) are linked with poorer participation and greater health service use, but long-term symptom heterogeneity remains incompletely defined.

Purpose

To identify model-based depressive symptom trajectories after spinal cord injury and examine their associations with 10-year rehospitalization, participation, complications, and related outcomes.

Methods

With a valid Patient Health Questionnaire-9 total score at year 1 and at least 1 additional valid score at years 5, 10, 15, or 20 formed the trajectory cohort (N = 3116).

n = 3116

Results

risk climbs to nearly a third when depression stays high for years

20.4%

Minimal symptoms

23.5%

Stable-low symptoms

24.7%

Early elevated-resolvi

28.1%

Late-elevating

More results

A 5-class solution was retained: minimal symptoms (11.4%), stable-low symptoms (29.4%), early elevated-resolving symptoms (10.2%), late-elevating symptoms (20.2%), and persistent elevated symptoms (28.8%).

More results

The persistent elevated and late-elevating patterns were also associated with lower adjusted participation and life satisfaction, greater pain and sleep burden, and higher probabilities of pressure ulcer and urinary tract infection.

“

Conclusion · 1 of 2

Long-term depressive symptom patterns after spinal cord injury were associated with clinically meaningful differences in 10-year outcomes.

Conclusion · 2 of 2

However, because most participants contributed only 2 PHQ-9 observations and late-wave data were sparse, these trajectories, particularly the late-elevating pattern, should be interpreted as probabilistic vulnerability markers rather than stable individual trajectories or causal phenotypes.

Depressive symptom trajectories after spinal cord injury: a secondary analysis of public-use data.

Depressive symptom trajectories after spinal cord injury: a secondary analysis of public-use data.

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