The connection between whiplash-associated disorders and anxiety
BACKGROUNDWhiplash-associated disorders (WAD) is a common name for a variety of clinical manifestations occuring after an accident with whiplash-mechanism. In the acute phase the patients often present with typical symptoms like neck pain, neck stiffness and headache. Most of the patients recover quickly after the accident, but some may develop chronic problems. The objective of this paper was a study of literature presented on the connection between WAD and anxiety.
METHODSI have searched electronic databases for literature on the topic. Articles containing material from clinical studies were included. The population consisted of patients having a whiplash associated disorder. There was no restrictions in studydesign. Titles of current interest were selected through a stepwise process. 13 articles were evalueted in the end.
RESULTSSeveral of the studies suggested that patients with WAD are suffering from anxiety more frequently than healthy controls from the general population. Some authors stated that anxiety develops secondary to chronic pain in these patients, while others thought that psychiatric disorders could be a riskfactor for developing symptoms after a whiplash injury. Anxiety was connected with poor prognosis for the WAD-patients. Symptoms of anxiety often arised early in the course of WAD, and then remained stable years after the accident. Patients experienced problems of functioning in daily life, and reported a higher level of distress than controls.
CONCLUSIONIt is important to discover and treat psychological problems in patients with WAD before the symptoms have stabilized, to prevent risk of chronical problems.