**2.8 Neuropsychiatric**

Depression, anxiety disorders, substance-related disorders, and suicidal tendencies are neuropsychiatric complications in these patients. Psychological support and counseling are essential.

Ditunno et al. [6]. described the loss of reflexes and recovery patterns in spinal shock patients in much detail depending upon duration following injury. He recognized four phases (Phase I–IV), phase I (Areflexia/hyporeflexia) postinjury day 0–1, phase II (Initial reflexes return) postinjury days 1–3, and phase III (Initial hyperreflexia) postinjury between days 4 and 1 month and phase IV (Final hyperreflexia) occurs between 1 and 12-months after injury.
