Citation

Carroll LJ, Liu Y, Holm LW, Cassidy JD, Côté P. Psychosom. Med. 2011; 73(8): 708-715.

Affiliation

Department Public Health Sciences (L.J.C., Y.L.) and Alberta Centre for Injury Control and Research (L.J.C.), University of Alberta, Edmonton, Alberta; and Institute for Clinical Evaluative Sciences (Y.L.), Toronto, Ontario, Canada; Institute of Environmental Medicine (L.W.H.), Karolinska Institutet, Stockholm, Sweden; Division of Health Care and Outcomes Research (J.D.C., P.C.), Toronto Western Research Institute, University Health Network; and Division of Epidemiology (J.D.C., P.C.), Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.

Copyright

(Copyright © 2011, American Psychosomatic Society, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/PSY.0b013e31822f991a

PMID

21949420

Abstract

Objective: Psychological factors such as depression affect recovery after whiplash-associated disorders. This study examined the prevalence of pain-related emotions, such as frustration, anger, and anxiety, and their predictive value for postcrash pain recovery during a 1-year follow-up. Methods: A population-based prospective cohort study design was used. Self-reported pain-related depression, anxiety, fear, anger, and frustration were assessed using 100-mm visual analog scales (VASs) at 6 weeks after crash in 2986 persons with traffic-related whiplash-associated disorder. Multivariable logistic regression was used to assess the relationship between the intensity of these pain-related emotions and pain recovery at 4 and 12 months after crash. Pain was measured at all time points on a 100-mm VAS, and pain recovery was defined as a score of 10 or lower. Results: Pain-related frustration was the most intense, with a mean score of 52. Only 3% of the cohort reported having no pain-related frustration, and 4% reported no pain-related anxiety. Multivariable logistic regression models revealed that each pain-related emotion increased the risk of failing to recover (odds ratios for each point increase on the 100-mm VAS), ranging from 1.011 to 1.015. Specifically, with each 10-point increase in pain-related emotion, the odds of failing to achieve pain recovery at 4 months was increased by 14% (p < .001) for depression, 15% (p < .001) for anxiety, 11% (p < .001) for fear, 12% (p < .001) for anger, and 11% (p < .001) for frustration. Conclusions: These findings suggest that it may be beneficial for health care providers to address emotional status related to pain in the first few weeks after a whiplash injury.

Language: en