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挥鞭伤患者心理变量的病程——对年龄、性别和教育程度配对的患者进行的为期2年的随访

Course of psychological variables in whiplash injury--a 2-year follow-up with age, gender and education pair-matched patients.

作者信息

Radanov Bogdan P, Begré Stefan, Sturzenegger Matthias, Augustiny Klaus F

机构信息

Department of Psychiatry, University of Berne, Inselspital, CH-3010 Berne, Switzerland Department of Internal Medicine, Psychosomatic Unit, University of Berne, Inselspital, CH-3010 Berne, Switzerland Department of Neurology, University of Berne, Inselspital, CH-3010 Berne, Switzerland.

出版信息

Pain. 1996 Mar;64(3):429-434. doi: 10.1016/0304-3959(95)00148-4.

Abstract

This study evaluated the course of psychological variables during a 2-year follow-up in patients after common whiplash of the cervical spine. From a sample of 117 non-selected patients with common whiplash (investigated on average 7.2 +/- 4.2 days after trauma) a total of 21 suffered trauma-related symptoms over 2 years following initial injury. These patients (symptomatic group) were compared with 21 age, gender and education pair-matched patients, who showed complete recovery from trauma-related symptoms during the 2-year follow-up (asymptomatic group). Both groups underwent standardised testing procedures (i.e., Freiburg Personality Inventory and Well-Being Scale) at referral, and at 3, 6 and 24 months. In the symptomatic group during follow-up no significant changes in rating of neck pain or headache were found. Significant differences between the groups and significant deviation of scores over time were found on the Well-Being and Nervousness Scales. There was a lack of significant difference between the groups on the Depression Scale, indicating a possible somatic basis for changes in psychological functioning in the investigated sample. With regard to scales of Extraversion or Neuroticism, there were neither significant differences between the groups nor significant deviation over time. These results highlight that patients' psychological problems are rather a consequence than a cause of somatic symptoms in whiplash.

摘要

本研究评估了颈椎常见挥鞭样损伤患者在2年随访期间心理变量的变化过程。从117例未经过筛选的常见挥鞭样损伤患者样本(创伤后平均7.2±4.2天接受调查)中,共有21例患者在初次受伤后的2年中出现了与创伤相关的症状。将这些患者(症状组)与21例年龄、性别和教育程度匹配的患者进行比较,后者在2年随访期间从创伤相关症状中完全康复(无症状组)。两组患者在转诊时以及3个月、6个月和24个月时均接受了标准化测试程序(即弗莱堡人格量表和幸福感量表)。在症状组随访期间,未发现颈部疼痛或头痛评分有显著变化。在幸福感量表和神经质量表上发现了两组之间的显著差异以及分数随时间的显著偏差。在抑郁量表上,两组之间没有显著差异,这表明在所研究的样本中,心理功能变化可能存在躯体基础。关于外向性或神经质量表,两组之间既没有显著差异,分数也没有随时间的显著偏差。这些结果突出表明,在挥鞭样损伤中,患者的心理问题更多是躯体症状的结果而非原因。

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