Suicidal Ideation Among Individuals Aging With Spinal Cord Injury.

Objective: To identify the prevalence of suicidal ideation (SI) and its correlates among an aging cohort of people with spinal cord injury (SCI) with an average of more than three decades of having lived with SCI. Research Method: The study was a cross-sectional analysis of self-report assessment data. These data were collected from 2018 to 2019 during the most recent data collection period of the 45-year SCI Longitudinal Aging Study. Participants (n = 553) were identified from specialty and university hospitals in the southeastern and midwestern United States. The participants averaged 31 years since SCI onset, with an average age of 58 years. Participants were predominantly non-Hispanic, White (79%), male (70.1%), and had a cervical level SCI (51%). Approximately 23% of participants were ambulatory. SI was assessed using a nonzero response to the ninth item on the Patient Health Questionnaire-9. Results: Over 14% of the sample endorsed experiencing recent SI. Bivariate analyses indicated that those with SI had greater pain severity, pain interference, depressive symptom severity, and frequency of anxiety. Having a cervical injury level, lower self-reported general health, instrumental social support, emotional social support, and fewer days spent outside the home were also associated with SI. Logistic regression analysis indicated that when all biopsychosocial variables were considered simultaneously, having a cervical-level injury and greater depressive symptom severity remained significantly associated with SI. Conclusion: The results of this study highlight the importance of continued assessment of depressive symptoms and SI as individuals age with SCI. Impact and Implications: This study presents data on the prevalence of suicidal ideation (SI) and examines biopsychosocial factors associated with SI in individuals who, on average, have over 30 years of lived experience with spinal cord injury (SCI). Individuals with SCI have higher rates of SI and suicide attempts than the general U.S. population and prior research on the SCI population has highlighted that fewer years since injury, depression, and alcohol abuse are associated with SI. Yet, there are few studies that examine SI with associated variables in people with SCI and those that exist are limited to individuals averaging fewer years postinjury (e.g., 11 years). The current study addresses the limitations of the existing literature by examining SI and associated factors in the aging SCI population. The current study results underscore the importance of continued clinical assessment of depressive symptoms and SI throughout the lifespan and inform potential intervention strategies for those with long-term SCI. [ABSTRACT FROM AUTHOR]