Clinical treatment and medication in decreasing the development of major depression caused by spinal fracture

Chih Yu Chang, Wen Liang Chen, Pei You Hsieh, Shinn Ying Ho, Cheng Chieh Huang, Tsung Han Lee, Chu Chung Chou, Chin Fu Chang, Yat Yin Law, Yan Ren Lin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background: Chronic pain and limited activities of daily living after spinal fracture may induce the occurrence of major depression (MD); however, risk factors regarding medications, surgical intervention, and severity of fracture are unclear. We aimed to analyze risk factors of MD development after spinal fracture. Methods: This was a retrospective database study, using the health care database of the Taiwan government. We included 11,225 patients with new spinal fracture (study group), and 33,675 matched patients without fracture (comparison group). We respectively reviewed data of each participant for 3 years to assess the development of MD. The Cox proportional hazards model was used to determine the prevalence of MD, after adjusting for patient demographics, medications, surgical interventions, spinal cord involvement, and postfracture comorbidities. Results: In total, 187 fracture patients (1.7%) and 281 nonfracture patients (0.8%) developed new-onset MD (hazard ratio [HR]:1.96, (95% confidence interval [CI]: 1.63–2.36)). Spinal cord involvement (HR: 2.96, 95% CI: 2.54–3.42) and postfracture comorbidities (HR: 3.51, 95% CI: 2.86–3.97) obviously increased the risk of MD. Conclusions: Patients with spinal fracture (spinal cord involvement and postfracture comorbidities) were more likely to develop MD. Early surgical interventions (vertebroplasty) and medications (narcotics) may decrease the risk of MD.

Original languageEnglish
JournalJournal of International Medical Research
Issue number11
StatePublished - 2020


  • activities of daily living
  • chronic pain
  • depression
  • narcotics
  • Spinal fracture
  • surgical intervention

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