Impact of COVID-19 on depression, anxiety, and quality of life in people with SCI

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Lay summary and infographic by Justin Yap

Edited by Crystal Han and Jocelyn Chan

This is a lay summary of the article by Alejandro García-Rudolph, Joan Saurí, Jaume López Carballo, Blanca Cegarra, Mark Andrew Wright, Eloy Opisso, Josep María Tormos. Read the original article here.


The COVID-19 pandemic has brought about many changes to the daily lives of individuals worldwide such as physical distancing, an increase in unemployment, and restrictions on services such as non-essential travel, businesses, and access to healthcare. Previous research has shown that individuals with disabilities during non-pandemic times are more likely to experience lower socioeconomic status, overall health and employment rates. While the impact may vary among individuals of different socioeconomic statuses, ages, regions and public health orders across the world, it remains unknown how the pandemic has affected the mental health of individuals with chronic spinal cord injury (SCI). 

What is the purpose of the study?

This study investigates the psychological effects of the COVID-19 pandemic on individuals with chronic SCI by comparing self-rating questionnaire scores on community integration, quality of life, anxiety and depression before and during COVID-19.  

How was the study conducted?

  1. 175 individuals with chronic SCI (tetraplegia/paraplegia) were included in this study based on past in-person assessments from a hospital 
  2. Researchers provided study participants with 3 types of online questionnaires:
    1. Hospital anxiety and depression scale (HADS): measures participants’ frequency of symptoms of anxiety and depression through a self-rated scale
    2. Community integration questionnaire (CIQ): measures participants’ engagement and frequency of engagement in 3 different categories
      1. Home integration (e.g. grocery shopping, household chores)
      2. Social integration (e.g. personal finances)
      3. Productive activities (e.g. work, volunteer)
    3. World health organization quality of life (WHOQOL-BREF): evaluates the quality of life through self-reported responses by participants to 26 different questions divided into 5 categories:
      1. Physical health 
      2. Psychological health 
      3. Social relationships 
      4. Environment
      5. Overall quality of life
  3. The scores from each questionnaire were compared to the participants’ previous responses before the pandemic

What were the main findings of the study?

During the COVID-19 pandemic participants with chronic SCI experienced:

  1. Increase likelihood of depression
  2. No difference in the likelihood of anxiety
  3. Decrease social integration
  4. Younger participants (19-54 years old) had lower WHOQOL-BREF score during COVID-19 compared to older participants (55+) who experienced no change. Researchers believe these differences can be explained by psychological resilience, which may serve a protective role in combating negative stressors.

Why is this important for the SCI community?

The COVID-19 pandemic had a negative impact on the mental health of individuals with chronic SCI, specifically feelings of depression and social integration. Further research should seek to improve the quality and accessibility of mental health resources for individuals with chronic SCI.

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