Display Settings:

Format

Send to:

Choose Destination

See 1 citation found using an alternative search:

See comment in PubMed Commons below
Arch Phys Med Rehabil. 2010 Aug;91(8):1218-24. doi: 10.1016/j.apmr.2010.04.015.

Factor structure and predictive validity of somatic and nonsomatic symptoms from the patient health questionnaire-9: a longitudinal study after spinal cord injury.

Author information

  • 1College of Health Professions, Medical University of South Carolina, Charleston, SC, USA. krause@musc.edu

Abstract

OBJECTIVE:

To investigate the factor structure and predictive validity of somatic and nonsomatic depressive symptoms over the first 2.5 years after spinal cord injury (SCI) using the Patient Health Questionnaire-9 (PHQ-9).

DESIGN:

Somatic and nonsomatic symptoms were assessed at baseline during inpatient hospitalization (average of 50 days after onset) and during 2 follow-ups (average of 498 and 874 days after onset).

SETTING:

Data were collected at a specialty hospital in the Southeastern United States and analyzed at a medical university. We performed time-lag regression between inpatient baseline and follow-up somatic and nonsomatic latent factors of the PHQ-9.

PARTICIPANTS:

Adults with traumatic SCI (N=584) entered the study during inpatient rehabilitation.

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURE:

PHQ-9, a 9-item measure of depressive symptoms.

RESULTS:

The inpatient baseline nonsomatic latent factor was significantly predictive of the nonsomatic (r=.40; P=.000) and somatic latent factors at the second follow-up (r=.29; P=.006), whereas the somatic factor at inpatient baseline did not significantly predict either factor. In contrast, when regressing latent factors between the 2 follow-ups, the nonsomatic factor predicted only the nonsomatic factor (r=.66; P=.002), and the somatic factor predicted only future somatic symptoms (r=.66; P=.000). In addition, the factor structure was not stable over time. Item analysis verified the instability of somatic items between inpatient baseline and follow-up and also indicated that self-harm at inpatient baseline was highly predictive of future self-harm.

CONCLUSIONS:

Nonsomatic symptoms are better predictors of future depressive symptoms when first assessed during inpatient rehabilitation, whereas somatic symptoms become stable predictors only after inpatient rehabilitation. Self-harm (suicidal ideation) is the most stable symptom over time. Clinicians should routinely assess for suicidal ideation and use nonsomatic symptoms when performing assessments during inpatient rehabilitation.

PMID:
20684902
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk