Treatment of Depression Following Spinal Cord Injury: An Evidence-Based Review.

quality of intervention studies of the treatment of depression among persons with SCI. Method: An extensive range of peer-reviewed published research was identified through established databases, critical reviews, and published meta-analyses. Results: Nine studies met the inclusion criteria. One antidepres-sant study was rated above Level III; although the psychological intervention studies had control groups, these were not randomized. Conclusion: This review demonstrates the need for randomized clinical trials of psychological and pharmacological interventions for depression and distress among persons with SCI, so that informed decisions concerning cost-effective treatments can be made. Depression has received more attention from clinicians and researchers than any other psychological issue among persons with spinal cord injuries (SCI; Elliott & Umlauf, 1995). For many years, clinical lore maintained that depression was to be expected soon after the onset of injury, and it was construed as a critical element in most anecdotal models of adjustment, typically signaling ratio-nal acceptance of the permanence of the injury (Frank, Elliott, Corcoran, & Wonderlich, 1987). Empirical study has broadened our understanding of depression considerably. Studies relying on