Epidemiology and psychological factors of whiplash associated disorders in Japanese population.
Hiroyuki Oka, Ko Matsudaira, Tomoko Fujii and 2 others
PMID 28931977WHAT IT FOUND
In Japanese adults, 1.2% had whiplash-associated disorder.
Those treated over 6 months reported more fear, catastrophizing, somatization, and depression, and had lower quality-of-life scores than those treated within 3 months.
Key findings
01Whiplash-associated disorder was present in 1.2% of Japanese adults, 1.3% of men and 1.0% of women.
02The intractable group had higher fear scores (44.0 vs 34.5 on a 17 to 68 scale) and higher pain catastrophizing scores (32.7 vs 17.5) than controls.
03The intractable group had lower EQ-5D quality-of-life scores (0.674 vs 0.923), more depression (54.1% vs 34.8% with SF-36 Mental Health score 52 or lower), and more somatization (85.8% vs 50.2% with Brief Symptom Inventory score 2 or higher) than controls.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was cross-sectional, so it cannot show whether psychological factors caused prolonged whiplash symptoms or were consequences of prolonged symptoms. Participants were internet research volunteers, and they were more likely than the general population to live in large cities and have university-level or graduate-level education. The control and intractable groups were defined by treatment duration, and the authors chose 3 months as early recovery without a prior definition. 44 of 974 secondary respondents were excluded because they were not wearing a seatbelt, and only 974 of 1,698 randomly selected collision participants returned the second questionnaire. Depression was defined by an SF-36 Mental Health cutoff score, not by clinical diagnosis.
The easy way to misread this
Do not conclude that fear, catastrophizing, depression, or somatization cause prolonged whiplash symptoms. This was a cross-sectional survey of internet volunteers, so it only shows that these factors were more common in the group treated over 6 months than in the group treated within 3 months.