Five years post whiplash injury: Symptoms and psychological factors in recovered versus non-recovered

A set of questionnaires was answered by 158 persons (75 men, 83 women) to assess disability (NDI), pain intensity (VAS), whiplash-related symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ), post-traumatic stress (Impact of Event Scale, IES), depression (Beck's depression inventory, BDI) and life satisfaction (LiSat-11).The participants were divided into three groups based on the results of the NDI: recovered (34.8%), mild disability (37.3%) and moderate/severe disability (27.3%).The moderate/severe group reported significantly higher VAS, BDI and IES scores and lower level of physical health and psychological health compared to the mild and the recovered groups. Less significant differences were reported between the mild and the recovered groups.The group with the highest disability score reported most health problems with pain, symptoms, depression, post-traumatic stress and decreased life satisfaction. These findings indicate that classifying these subjects into subgroups based on disability levels makes it possible to optimize the management and treatment after whiplash injury.The incidence rate of whiplash injuries in Sweden is estimated to be 1.0-3.2/1000/year [1]. The injuries constitute a major health problem in Western society due to the large number of people with Whiplash associated disorder (WAD) and the high economical costs associated with WAD [2,3] People with acute WAD, mainly complain of neck-pain, stiffness, headache and dizziness. Other symptoms that may occur after the injury are fatigue, concentration and memory problems [2,4]. Most subjects with acute WAD are reported to recover within three months of the trauma [4] however, a significant number of persons experience symptoms several years after the accident [1,5]. Persistent neck-pain has been reported in 84-90% one to two year and in 55% 17 years after the injury [6].It is still unclear why pain and related symptoms do not resolve after the expected time of healing and which fact