• Mohammad Mofatteh, Mohammad Sadegh Mashayekhi, Saman Arfaie, Yimin Chen, Armaan K Malhotra, Georgios P Skandalakis, Mohammed Ali Alvi, Fardad T Afshari, Shakila Meshkat, Famu Lin, Ebtesam Abdulla, Ayush Anand, Xuxing Liao, Roger S McIntyre, Carlo Santaguida, Michael H Weber, and Michael G Fehlings.
• School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK; Neuro International Collaboration (NIC), London, UK. Electronic address: mmofatteh01@qub.ac.uk.
• World Neurosurg. 2024 Apr 1; 184: 267282.e5267-282.e5.

BackgroundTraumatic spinal cord injury (TSCI) is a debilitating neurological condition with significant long-term consequences on the mental health and well-being of affected individuals. We aimed to investigate anxiety and depression in individuals with pediatric-onset TSCI.MethodsPubMed, Scopus, and Web of Science databases were searched from inception to December 20th, 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, and studies were included according to the eligibility criteria.ResultsA total of 1013 articles were screened, and 18 studies with 4234 individuals were included in the final review. Of these, 1613 individuals (38.1%) had paraplegia, whereas 1658 (39.2%) had tetraplegia. A total of 1831 participants (43.2%) had complete TSCI, whereas 1024 (24.2%) had incomplete TSCI. The most common etiology of TSCI with 1545 people (36.5%) was motor vehicle accidents. The youngest mean age at the time of injury was 5.92 ± 4.92 years, whereas the oldest was 14.6 ± 2.8 years. Patient Health Questionnaire-9 was the most common psychological assessment used in 9 studies (50.0%). Various risk factors, including pain in 4 studies (22.2%), reduced sleep quality, reduced functional independence, illicit drug use, incomplete injury, hospitalization, reduced quality of life, and duration of injury in 2 (11.1%) studies, each, were associated with elevated anxiety and depression.ConclusionsDifferent biopsychosocial risk factors contribute to elevated rates of anxiety and depression among individuals with pediatric-onset TSCI. Individuals at risk of developing anxiety and depression should be identified, and targeted support should be provided. Future large-scale studies with long-term follow-up are required to validate and extend these findings.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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