Adults with a spinal cord injury have a higher incidence of and risk for common psychological morbidities such as depression and anxiety, according to a study by the University of Michigan, Michigan Medicine and published in the medical journal Spinal Cord.

A team of researchers with the Ann Arbor, Michigan-based medical school analyzed private insurance claims from more than 9,000 adults with a traumatic spinal cord injury, and more than 1 million adults without. Accounting for a range of psychological conditions, from anxiety and mood disorders to insomnia and dementia, researchers found that people living with a spinal cord injury were diagnosed with a mental health condition more often than those without the injury — 59.1% versus 30.9%.

The study found that chronic centralized and neuropathic pain among adults living with a spinal cord injury was found to be “robustly associated” with post-traumatic stress disorder, substance use disorders and other mental health conditions. In most cases, researchers found that chronic pain had the greatest influence on mental health.

Researchers say the findings should prompt physicians to identify mental health conditions when seeing patients with spinal cord injuries and refer them to mental health providers for treatment.

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