Citation

Kenardy J, Heron-Delaney M, Warren J, Brown E. Arch. Phys. Med. Rehabil. 2014; 96(3): 410-417.

Affiliation

Centre of National Research on Disability and Rehabilitation Medicine (CONROD), School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.apmr.2014.10.007

PMID

25450121

Abstract

OBJECTIVE: To investigate the relationship between mental health and disability following a road traffic crash (RTC) up to 24 months for claimants with predominantly minor injuries in an Australian sample.

DESIGN: Longitudinal cohort study with survey and telephone interview data collected at approximately 6, 12 and 24 months post-RTC. SETTING: Claimants within a common-law, fault-based compulsory third party motor accident insurance scheme in Queensland, Australia PARTICIPANTS: A total of 382 claimants consented to participate when invited, and were approached at each wave. Retention was high (65%) at two year follow-up. Disability scores from at least one wave were known for 363 participants, with the average age of participants being 48.4 years and 62% being female. INTERVENTIONS: Not Applicable. MAIN OUTCOME MEASURE: Self-reported disability (WHO-DAS-II) RESULTS: Participants reported higher disability (M=10.9; SD=9.3) compared to the Australian norms (M=3.1; SD=5.3). A multilevel regression analysis found predictors of disability included present diagnosis of Posttraumatic Stress Disorder (PTSD), anxiety or depression, mental health history, perceived threat to life and pain. PTSD moderated the relationship between age and disability such that older age predicted higher disability in the PTSD group only, while anxiety moderated the relationship between expectation to return to work and disability such that those with low expectations and anxiety reported significantly higher disability.

CONCLUSION: Claimants with predominantly minor physical injuries report high disability, particularly when co-morbid psychiatric disorders are present, pain is high and expectations regarding return to work are low. Developing tools for detecting those at risk of poor recovery following an RTC is necessary for informing policy and practice in injury management and post-injury rehabilitation.

Language: en