1. What characterizes individuals developing chronic whiplash?: The Nord-Trøndelag Health Study (HUNT)
- Author
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Keith J. Petrie, Jens Christoffer Skogen, Børge Sivertsen, Solbjørg Makalani Myrtveit, and Ingvard Wilhelmsen
- Subjects
Adult ,Male ,Musculoskeletal pain ,medicine.medical_specialty ,Prescription Drugs ,Physical activity ,Logistic regression ,Cohort Studies ,Young Adult ,Health services ,Risk Factors ,Adaptation, Psychological ,Whiplash ,Humans ,Medicine ,Prospective Studies ,Risk factor ,Somatoform Disorders ,Whiplash Injuries ,Aged ,Illness Behavior ,Pain Measurement ,Norway ,business.industry ,Health Services ,Middle Aged ,Prognosis ,medicine.disease ,Anxiety Disorders ,Health Surveys ,Psychiatry and Mental health ,Clinical Psychology ,Whiplash injury ,Chronic Disease ,Compensation and Redress ,Utilization Review ,Physical therapy ,Anxiety ,Female ,medicine.symptom ,business ,human activities - Abstract
Objective Most individuals experiencing whiplash accidents recover rapidly. A considerable proportion, however, develop chronic symptoms. Psychological factors may slow recovery, possibly by increasing the likelihood of other symptoms being misattributed to, and amplified by the whiplash injury. We aimed to investigate how pre-injury mental and somatic symptoms, self-rated health, use of health-services and medications, health-behavior and socio-demographics predict the development of chronic whiplash. Methods Data from two waves of a large, population based study (HUNT2 (baseline) and HUNT3) were used. Individuals reporting no whiplash at baseline were identified in HUNT3. Characteristics reported at baseline were compared between those who had developed chronic whiplash in HUNT3 (n = 199) and those who had not (n = 20,600), using Pearson's chi-squared tests, independent sample t-tests and logistic regression analyses. Results Individuals developing chronic whiplash reported worse baseline health than those reporting no chronic whiplash. Poor self-rated health was a strong risk factor for subsequent chronic whiplash (OR = 2.26, 95%CI: 1.68–3.04). Musculoskeletal pain also increased the risk (OR = 1.21, 95%CI: 1.15–1.26), as did diffuse somatic symptoms (OR = 2.09, 95%CI: 1.47–2.96), use of different health services (OR = 1.31, 95%CI: 1.19–1.45), high use of medications (OR = 1.28, 95%CI: 1.14–1.43) and symptoms of anxiety (OR = 1.93, 95%CI: 1.39–2.68). Physical activity was protective (OR = 0.67, 95%CI: 0.49–0.91). Most socio-demographic variables were not significantly associated with chronic whiplash. Conclusion Poor somatic and mental pre-injury health increased the risk of subsequent chronic whiplash. This suggests that chronic whiplash is not merely an organic disorder, and highlights the importance of individual expectations, symptom reattribution and amplification in development of chronic whiplash.
- Published
- 2013
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