Psychological Distress, Pain and Insurance Claims Negatively Affect Long-Term Health-Related Quality of Life After Road Traffic Injuries.
Kevin K C Hung, Annette Kifley, Katherine Brown and 8 others
PMID 35735901WHAT IT FOUND
At 12 months after road traffic injury, higher early pain, psychological distress and insurance claims were linked with poorer physical and mental quality of life, even after accounting for injury severity.
Key findings
01Higher baseline pain, psychological distress, pain catastrophizing and CTP claimant status were each linked with lower 12-month physical component scores after adjustment.
02High depression/anxiety/stress and post-traumatic stress symptoms were linked with lower 12-month mental component scores; pain catastrophizing was significant in moderate and severe groups but not mild, and CTP claimant status was also associated with lower mental scores.
03Injury severity affected long-term physical outcomes partly through early pain and psychological factors, while its effect on mental outcomes was indirect.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 60% of the original participants completed the 12-month follow-up, so the long-term results depend on a majority who stayed in the study. This was an observational cohort, not a trial, so it cannot show that pain, distress or claims caused poorer outcomes. Injury severity was based on self-reported length of hospital stay, which can be influenced by other health problems and hospital practice, not only by the injury itself. The psychological measures were screening scales, not clinical diagnoses made by mental health professionals. Pre-injury information was recalled after the crash, so some participants may have remembered it imperfectly. Although mental component scores were lower with longer hospital stay, the difference between groups was small. Some pain-rating associations with mental scores disappeared after further adjustment.
The easy way to misread this
Do not read these results as proof that insurance claims cause poorer recovery or that treating pain and distress will improve quality of life. This was an observational cohort, and the authors state causation cannot be inferred.