Carroll Linda J, Cassidy J David, Côté Pierre
Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada.
Spine (Phila Pa 1976). 2006 Jul 15;31(16):E551-6. doi: 10.1097/01.brs.0000225979.26966.9e.
Population-based incidence cohort.
To report the incidence, timing, and course of depressive symptoms after whiplash.
Evidence is conflicting about the frequency, time of onset, and course of depressive symptoms after whiplash.
Adults making an insurance claim or seeking health care for traffic-related whiplash were followed by telephone interview at 6 weeks, and 3, 6, 9, and 12 months post-injury. Depressive symptoms were assessed at baseline and at each follow-up.
Of the 5,211 subjects reporting no pre-injury mental health problems, 42.3% (95% confidence interval, 40.9-43.6) developed depressive symptoms within 6 weeks of the injury, with subsequent onset in 17.8% (95% confidence interval, 16.5-19.2). Depressive symptoms were recurrent or persistent in 37.6% of those with early post-injury onset. Pre-injury mental health problems increased the risk of later onset depressive symptoms and of a recurrent or persistent course of early onset depressive symptoms.
Depressive symptomatology after whiplash is common, occurs early after the injury, and is often persistent or recurrent. This suggests that, like neck pain and headache, depressed symptomatology is part of the cluster of acute whiplash symptoms. Clinicians should be aware of both physical and psychologic injuries after traffic collisions.
基于人群的发病率队列研究。
报告挥鞭样损伤后抑郁症状的发病率、发生时间及病程。
关于挥鞭样损伤后抑郁症状的发生频率、发病时间及病程，证据存在矛盾之处。
对因交通相关挥鞭样损伤提出保险索赔或寻求医疗护理的成年人，在受伤后6周以及3、6、9和12个月进行电话随访。在基线及每次随访时评估抑郁症状。
在5211名报告伤前无心理健康问题的受试者中，42.3%（95%置信区间为40.9 - 43.6）在受伤后6周内出现抑郁症状，随后17.8%（95%置信区间为16.5 - 19.2）发病。在伤后早期发病的患者中，37.6%的抑郁症状呈复发或持续状态。伤前心理健康问题增加了后期发生抑郁症状以及早期发病的抑郁症状呈复发或持续病程的风险。
挥鞭样损伤后的抑郁症状很常见，在受伤后早期出现，且常为持续性或复发性。这表明，与颈部疼痛和头痛一样，抑郁症状是急性挥鞭样损伤症状群的一部分。临床医生应意识到交通碰撞后身体和心理两方面的损伤。
