Letter to the editor: Integrating psychological care into postoperative spinal cord injury rehabilitation: An imperative based on recent evidence

Table 1 Risk factors for postoperative anxiety/depression in patients with spinal cord injury and proposed stratified intervention strategies

Independent risk factor	Stratified intervention strategy	Evidence/remarks
Male sex	Male-friendly intervention models (e.g., activity-based peer support, integrating psychological discussions into physical therapy)	Overcomes inhibition of emotional expression by traditional gender roles
PSQI score ≥ 13 (sleep disturbance)	Optimize sleep management: Introduce evidence-based protocols such as CBT-I	Modifiable therapeutic target; improving sleep indirectly alleviates psychological distress
ASIA grades A-B	Integrate psychological techniques, e.g., mindfulness-based stress reduction	Targets frustration from severe functional loss
Age ≥ 60 years	Adaptive psychological counseling, linkage to social support resources	Addresses specific psychological challenges of aging
Disease duration ≥ 12 months	Establish long-term support networks, focus on chronic psychological burden	Transition from acute management to longterm rehabilitation support
Education below senior high school	Use easy-to-understand health education materials	Enhances disease understanding and perceived control

PSQI: Pittsburgh Sleep Quality Index; CBT-I: Cognitive behavioral therapy for insomnia; ASIA: American Spinal Injury Association.