Perceived functional impairment and spirituality/religiosity as predictors of depression in a Sri Lankan spinal cord injury patient population.

STUDY DESIGN: Cross-sectional, questionnaire-based study.

OBJECTIVES: To test the hypothesis that self-perceived functional impairment and religiosity/spirituality (S/R) predict depression among traumatic spinal cord injury (SCI) patients in Sri Lanka.

SETTING: Ragama Rheumatology and Rehabilitation Hospital, Ragama, Sri Lanka.

METHODS: The Spinal Cord Independence Measure, Benefit Through Spirituality/Religiosity Scale, Sheehan Disability Inventory and Beck Depression Inventory-II (BDI-II) were administered to 61 consenting in-patients with traumatic SCI between June and July 2014. A linear regression model on BDI-II score was developed to examine the impact of self-perceived functional impairment and S/R activities on psychiatric outcomes in context of various sociodemographic variables.

RESULTS: Psychiatric consequences of SCI were reflected in a 41% prevalence of depression. Thirty-six percent (R(2)=0.36) of the variance in BDI-II scores (F(5, 55)=6.07, P<0.001) was explained by the regression model. Functional impairment (β=0.54, t(55)=4.73, P<0.001) and perceived benefit through S/R activities (β=-0.31, t(55)=-2.55, P<0.05) emerged as the strongest predictors for depression severity.

CONCLUSIONS: Perceived functional impairment in work, social and family domains predicted depressive symptomatology among SCI inpatients in Sri Lanka, while perceived benefit through S/R protected against depression. The findings emphasize the need for rehabilitative programming to support patients' S/R activities and mental wellbeing, promoting reintegration into their community roles.