Radanov P, Sturzenegger M, Di Stefano G
Psychiatrische Universitätspoliklinik, Bern.
Orthopade. 1994 Aug;23(4):282-6.
The purpose of the present study was to investigate the predictive relationship between psychosocial factors and the course of recovery in patients with whiplash injury. A non-selected sample of 117 subjects satisfying to a clear definition of the syndrome was assessed early after trauma (mean 7.4 +/- 4.2 days) and again at 3, 6, and 12 months. Initial evaluation included subjective complaints (including timing of symptom onset and initial pain intensity) and a large number of psychosocial factors (e.g., self-ratings of well-being, personal and family history, personality traits, and cognitive functioning). Rate of recovery was assessed at follow-ups. One year after initial trauma patients were divided in two groups (recovered and still symptomatic) and compared with regard to initial findings. Finally, a regression analysis was performed with all baseline variables, employing groups (recovered vs symptomatic) as factor variables. Patients who remained symptomatic at 1 year had significantly higher ratings of initial neck pain and headache, displayed a greater variety of subjective complaints, higher scores on the scale "nervousness" from the personality inventory, worse well-being score and poorer performance with regard to focussed attention. According to the regression analysis the following set of initial variables was in significant relationship with poor recovery at 1 year: higher age, complaint of sleep disturbances at initial investigation, and higher intensity of initial neck pain and headache.
本研究的目的是调查心理社会因素与挥鞭样损伤患者恢复过程之间的预测关系。对117名符合该综合征明确定义的非选择性样本在创伤后早期(平均7.4±4.2天)进行评估,并在3个月、6个月和12个月时再次评估。初始评估包括主观症状(包括症状发作时间和初始疼痛强度)以及大量心理社会因素(例如,幸福感自评、个人和家族史、人格特质和认知功能)。在随访时评估恢复率。初始创伤一年后,将患者分为两组(已康复和仍有症状),并根据初始检查结果进行比较。最后,以组(已康复与有症状)作为因素变量,对所有基线变量进行回归分析。一年后仍有症状的患者初始颈部疼痛和头痛评分显著更高,表现出更多样化的主观症状,在人格量表“神经质”上得分更高,幸福感得分更低,在集中注意力方面表现更差。根据回归分析,以下一组初始变量与一年后恢复不佳有显著关系:年龄较大、初始检查时有睡眠障碍主诉、初始颈部疼痛和头痛强度较高。