Whiplash-associated disorders: who gets depressed? Who stays depressed?
From: Eur Spine J. 2010 Feb 2. [Epub ahead of print]
Depression is common in whiplash associated disorders. Our objectives were to identify factors associated with depressive symptomatology occurring in the initial stages of whiplash associated disorders, and to identify factors predicting the course of depressive symptoms. A population-based cohort of adults sustaining traffic related whiplash associated disorders was followed at 6 weeks, 3, 6, 9, and 12 months. Baseline measures (assessed a median of 11 days post-crash) included demographic and collision-related factors, prior health, and initial post-crash pain and symptoms. Depressive symptomatology was assessed at baseline and at each follow-up using the Centre for Epidemiological Studies Depression Scale (CES-D). The authors’ included only those who participated at all follow-ups (n = 3,452; 59% of eligible participants). Using logistic regression, they identified factors associated with initial (post-crash) depression. Using multinomial regression, we identified baseline factors predicting course of depression.
Courses of depression were no depression; initial depression that resolves, recurs or persists, and later onset depression. Factors associated with initial depression included greater neck and low back pain severity, greater percentage of body in pain, numbness/tingling in arms/hand, dizziness, vision problems, post-crash anxiety, fracture, prior mental health problems, and poorer general health.
Predictors of persistent depression included older age, greater initial neck and low back pain, post-crash dizziness, vision and hearing problems, numbness and/or tingling in arms and/or hands, anxiety, prior mental health problems, and poorer general health. Recognition of these underlying risk factors may assist health care providers to predict the course of psychological reactions and to provide effective interventions.
Related Source:
Relationship between symptoms and psychological factors five years after whiplash injury 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.
