Citation

Mykletun A, Glozier N, Wenzel HG, Overland S, Harvey SB, Wessely S, Hotopf M. Spine 2011; 36(17): 1380-1386.

Affiliation

1University of Bergen, Faculty of Psychology, HEMIL, Mental Health Epidemiology, Bergen, Norway 2Norwegian Institute of Public Health, Division of Mental Health, Oslo, Norway 3The University of Sydney, Sydney, Australia 4Norwegian University of Technology and Science, Trondheim, Norway 5Institute of Psychiatry, Kings College London, Division of Psychological Medicine, London, UK.

Copyright

(Copyright © 2011, Lippincott Williams and Wilkins)

DOI

10.1097/BRS.0b013e3181f2f6bb

PMID

21217426

Abstract

Study design: Longitudinal population based cohort study.Objective: The aim of the present study was to examine the possibility of reverse causality, that is, if symptoms of anxiety and depression are associated with incident self-reported whiplash injury. The clinical relevance of self-reported whiplash injury was evaluated by its association with subsequent disability pension award.Summary of Background Data: Whiplash is associated with an increased level of anxiety and depressive symptoms. This increase in psychological distress is generally understood as the consequence of the accident and related whiplash.Methods: Longitudinal data from the HUNT study with baseline measures of symptoms of anxiety and depression was used (n = 37792), and the outcome of self-reported incident whiplash injury occurring between baseline and follow-up 11 years later. Incident disability pension award was obtained from a comprehensive national registry during two years follow-up after self-reported whiplash injury.Results: Case-level symptom load of anxiety and depression at baseline increased the likelihood of reporting incident whiplash at follow-up (OR = 1.60, 95% CI 1.22 - 2.11). Self-reported whiplash increased the chances of a subsequent disability pension award (OR = 6.54), even in the absence of neck pain (OR = 3.48).Conclusion: This is the first published study with a pre-whiplash prospective evaluation of psychological status. Our findings are in conflict with previous research suggesting whiplash to be the cause of associated psychological symptoms rather than its consequence. Self-reported whiplash injury was clinically relevant as it independently increased subsequent disability pension award. The strength of this effect, even in the absence of neck pain, suggests the ascertainment of this diagnostic label, or factors associated with this, are important predictors of disability.

Language: en