Relationship between symptoms and psychological factors five years after whiplash injury

The aims of this study were: to describe the frequency of whiplash-related symptoms and psychological factors in persons 5 years after a whiplash injury; to study the relationship between symptoms and psychological factors; to examine gender differences; and to investigate the cause of sick leave.

Questionnaires addressing neck pain, pain intensity, whiplash-related symptoms, post-traumatic stress, depression, social support and life satisfaction were used.

Neck pain was reported by 59% of subjects, whiplash-related symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ) by 76%, depression (Beck's Depression Inventory, BDI) by 22%, and post-traumatic stress (Impact of Event Scale, IES), by 38%. The scores of pain intensity and RPQ were correlated to BDI, IES and LiSat-11 scores. Men reported a lower level of quality of social support than women. Men reporting many symptoms also reported reduced availability of social interaction, whereas women with many symptoms reported reduced availability of attachment (i.e. lack of intimate partner, close family and friends). A multivariate logistic regression showed an association between sick leave and depression.

These findings indicate the importance of assessing possible relationships between symptoms, depression and post-traumatic stress in persons with long-term problems after whiplash injury, and of treating existing symptoms, especially depression. Because social support may play a role in recovery, social relationships should also be examined.