Do Acute Illness Perceptions Moderate the Association of Pre-Collision Welfare Benefits and Later Neck Pain or...

Objectives: Whiplash trauma is a worldwide significant public health issue, with post-collision chronic pain and physical and mental disability; the prevalence of whiplash trauma in the Japanese general population is estimated at 1.2% and in the Danish general population the whiplash condition has been reported to be 2.9%. Pre-collision welfare benefits and illness perceptions have been found to predict poor recovery after whiplash trauma. In this study, we examined whether illness perceptions measured shortly post-collision moderated the effect of welfare benefits five years before the collision on neck pain and neck-related disability one-year post-collision. Methods: Patients consulting emergency rooms or general practices with neck pain after acute whiplash trauma were invited to complete questionnaires during the week after the collision and at three and 12-months post-collision. Further, we obtained register data on the number of weeks on three types of welfare benefits (sick leave benefits, unemployment benefits, and social assistance benefits) for a five-year period before the collision. Multiple logistic regression was applied. Results: 740 patients were included. We did not find a significant moderating effect of illness perceptions on the association between pre-collision welfare benefits and chronic neck pain and related disability. However, there was a trend towards illness perceptions at baseline and at the three-month follow-up having a moderating effect on the relationship between long-term sick leave and neck pain one year after the whiplash collision. Conclusions: Regarding long-term sick leave, we might have overlooked a substantial moderating effect due to methodological matters and recommend a replication of this study on a larger sample, also focusing on other recovery outcomes.