• I-Hsuan Tsai, Daniel E Graves, Ching-Huang Lai, Lu-Yu Hwang, and Lisa A Pompeii.
• School of Public Health, University of Texas Health Science Center at Houston, Houston, TX. Electronic address: I-Hsuan.Tsai@uth.tmc.edu.
• Arch Phys Med Rehabil. 2014 Feb 1; 95 (2): 236-43.

ObjectiveTo examine the relation between the frequency of Internet use and depression among people with spinal cord injury (SCI).DesignCross-sectional survey.SettingSCI Model Systems.ParticipantsPeople with SCI (N=4618) who were interviewed between 2004 and 2010.InterventionsNot applicable.Main Outcome MeasuresThe frequency of Internet use and the severity of depressive symptoms were measured simultaneously by interview. Internet use was reported as daily, weekly, monthly, or none. The depressive symptoms were measured by the Patient Health Questionnaire-9 (PHQ-9), with 2 published criteria being used to screen for depressive disorder. The diagnostic method places more weight on nonsomatic items (ie, items 1, 2, and 9), and the cut-off method that determines depression by a (PHQ-9) score ≥10 places more weight on somatic factors. The average scores of somatic and nonsomatic items represented the severity of somatic and nonsomatic symptoms, respectively.ResultsOur multivariate logistic regression model indicated that daily Internet users were less likely to have depressive symptoms (odds ratio=.77; 95% confidence interval, .64-.93), if the diagnostic method was used. The linear multivariate regression analysis indicated that daily and weekly Internet usage were associated with fewer nonsomatic symptoms; no significant association was observed between daily or weekly Internet usage and somatic symptoms.ConclusionsPeople with SCI who used the Internet daily were less likely to have depressive symptoms.Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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