Stålnacke Britt-Marie
Department of Community Medicine and Rehabilitation (Rehabilitation Medicine), Umeå University, Umeå, Sweden.
Ment Illn. 2010 Apr 14;2(1):e4. doi: 10.4081/mi.2010.e4. eCollection 2010 Jan 25.
Psychological factors such as post-traumatic stress and depression may play an important role in the recovery after whiplash injuries. Difficulties in psychosocial functioning with limitations in everyday life may dominate for some time after the injury. Our study therefore investigates the relationships between pain, post-traumatic stress, depression, and community integration. A set of questionnaires was answered by 191 persons (88 men, 103 women) five years after a whiplash injury to assess pain intensity (visual analogue scale, VAS), whiplash-related symptoms, post-traumatic stress (impact of event scale, IES), depression (Beck depression inventory, BDI-II), community integration (community integration questionnaire, CIQ), life satisfaction (LiSat-11). One or more depressive symptoms were reported by 74% of persons; 22% reported scores that were classified as mild to severe depression. The presence of at least one post-traumatic symptom was reported by 70% of persons, and 38% reported mild to severe stress. Total scores of community integration for women were statistically significantly higher than for men. The total VAS score was correlated positively to the IES (r=0.456, P<0.456), the BDI (r=0.646, P<0.001), and negatively to the CIQ (r=-0.300, P<0.001). These results highlight the view that a significant proportion of people experience both pain and psychological difficulties for a long time after a whiplash injury. These findings should be taken into consideration in the management of subjects with chronic whiplash symptoms and may support a multi-professional rehabilitation model that integrates physical, psychological, and psychosocial factors.
创伤后应激障碍和抑郁症等心理因素可能在挥鞭伤后的恢复过程中发挥重要作用。受伤后的一段时间内，心理社会功能方面的困难以及日常生活中的限制可能会占据主导。因此，我们的研究调查了疼痛、创伤后应激障碍、抑郁症与融入社区之间的关系。191人（88名男性，103名女性）在挥鞭伤五年后回答了一组问卷，以评估疼痛强度（视觉模拟量表，VAS）、与挥鞭伤相关的症状、创伤后应激障碍（事件影响量表，IES）、抑郁症（贝克抑郁量表，BDI-II）、融入社区情况（社区融入问卷，CIQ）以及生活满意度（LiSat-11）。74%的人报告有一项或多项抑郁症状；22%的人报告的分数被归类为轻度至重度抑郁。70%的人报告至少有一种创伤后症状，38%的人报告有轻度至重度应激。女性的社区融入总得分在统计学上显著高于男性。VAS总分与IES呈正相关（r = 0.456，P < 0.456），与BDI呈正相关（r = 0.646，P < 0.001），与CIQ呈负相关（r = -0.300，P < 0.001）。这些结果凸显了这样一种观点，即相当一部分人在挥鞭伤后很长一段时间内都同时经历疼痛和心理困难。在管理患有慢性挥鞭伤症状的患者时应考虑这些发现，并且这些发现可能支持一种整合身体、心理和心理社会因素的多专业康复模式。
