Stålnacke Britt-Marie
Department of Community Medicine and Rehabilitation (Rehabilitation Medicine), Bldg 9A, Umeå University Hospital, Umeå University, SE-90185 Umeå, Sweden.
J Rehabil Med. 2009 Apr;41(5):353-9. doi: 10.2340/16501977-0349.
The aims of this study were: to describe the frequency of whiplash-related symptoms and psychological factors in persons 5 years after a whiplash injury; to study the relationship between symptoms and psychological factors; to examine gender differences; and to investigate the cause of sick leave.
Questionnaires addressing neck pain, pain intensity, whiplash-related symptoms, post-traumatic stress, depression, social support and life satisfaction were used.
Neck pain was reported by 59% of subjects, whiplash-related symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ) by 76%, depression (Beck's Depression Inventory, BDI) by 22%, and post-traumatic stress (Impact of Event Scale, IES), by 38%. The scores of pain intensity and RPQ were correlated to BDI, IES and LiSat-11 scores. Men reported a lower level of quality of social support than women. Men reporting many symptoms also reported reduced availability of social interaction, whereas women with many symptoms reported reduced availability of attachment (i.e. lack of intimate partner, close family and friends). A multivariate logistic regression showed an association between sick leave and depression.
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.
本研究的目的是:描述挥鞭样损伤5年后人群中与挥鞭样损伤相关症状和心理因素的发生频率;研究症状与心理因素之间的关系;检查性别差异;并调查病假的原因。
使用了针对颈部疼痛、疼痛强度、与挥鞭样损伤相关症状、创伤后应激、抑郁、社会支持和生活满意度的问卷。
59%的受试者报告有颈部疼痛,76%的受试者报告有与挥鞭样损伤相关症状(Rivermead脑震荡后症状问卷,RPQ),22%的受试者报告有抑郁(贝克抑郁量表,BDI),38%的受试者报告有创伤后应激(事件影响量表,IES)。疼痛强度和RPQ得分与BDI、IES和LiSat-11得分相关。男性报告的社会支持质量水平低于女性。报告有许多症状的男性还报告社交互动的机会减少,而有许多症状的女性报告依恋机会减少(即缺乏亲密伴侣、亲密家人和朋友)。多因素逻辑回归显示病假与抑郁之间存在关联。
这些发现表明,评估挥鞭样损伤后长期存在问题的人群中症状、抑郁和创伤后应激之间可能存在的关系,以及治疗现有症状,尤其是抑郁,具有重要意义。由于社会支持可能在康复中发挥作用,因此也应检查社会关系。