Pain-Related Emotions in Early Stages of Recovery in Whiplash-Associated Disorders: Their Presence, Intensity, and Association With Pain Recovery
From: Psychosom Med. 2011 Sep 23. [Epub ahead of print]
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.
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 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 visual analog scales, and pain recovery was defined as a score of 10 or lower.
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. 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% for depression, 15% for anxiety, 11% for fear, 12% for anger, and 11% for frustration.
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.