NOSOLOGICAL ENTITIES?: The late whiplash syndrome: a biopsychosocial approach

Ferrari, Roberto; Schrader, Harald

doi:10.1136/jnnp.70.6.722

Cited by 111 publications

(64 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…But they found no correlation between personality traits and the course of recovery from whiplash, in agreement with a recent study by Borchgrevink et al [4]. Contrary to this, previous studies [7,13,15,17,33] have suggested whiplash injuries to be psychogenic in origin and create or contribute to somatic symptoms after whiplash injury.…”

Section: Introductionsupporting

confidence: 85%

Temperament and character: prognostic factors in whiplash patients?

et al. 2004

View full text Add to dashboard Cite

show abstract

Section: Introductionsupporting

confidence: 85%

Temperament and character: prognostic factors in whiplash patients?

et al. 2004

View full text Add to dashboard Cite

show abstract

“…Also, after 1 year it was observed that considerable headache was more frequent in the group with traumatic findings (OR 2.8; 95 CI 0. [4][5][6][7][8][9][10][11][12][13][14][15][16][17] and this group had a higher median headache intensity (Table 6). These above mentioned associations were not significant and the group did not differ otherwise from other participants ( Table 7).…”

Section: Associations Between Mri Findings and Outcomementioning

confidence: 99%

“…Most likely, several different aetiologies exist behind WAD and it seems relevant to address all components of the bio-psycho-social model in order to understand chronic WAD [11,36]. Also, cultural factors such as compensation systems [6,7] and general expectations of long-lasting symptoms [10,27] seems to influence the prognosis after whiplash.…”

mentioning

confidence: 99%

Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

et al. 2008

View full text Add to dashboard Cite

Neck pain is the cardinal symptom following whiplash injuries. The trauma mechanism could theoretically lead to both soft tissue and bone injury that could be visualised by means of MRI. From previous quite small trials it seems that MRI does not demonstrate significant tissue damage. Large prospectively followed cohorts are needed to identify possible clinically relevant MRI findings. The objective of this trial was to evaluate (1) the predictive value of cervical MRI after whiplash injuries and (2) the value of repeating MRI examinations after 3 months including sequences with flexion and extension of the cervical spine. Participants were included after rearend or frontal car collisions. Patients with fractures or dislocations diagnosed by standard procedures at the emergency unit were not included. MRI scans of the cervical spine were performed at baseline and repeated after 3 months. Clinical follow-ups were performed after 3 and 12 months. Outcome parameters were neck pain, headache, neck disability and working ability. A total of 178 participants had a cervical MRI scan on average 13 days after the injury. Traumatic findings were observed in seven participants. Signs of disc degeneration were common and most frequent at the C5-6 and C6-7 levels. Findings were not associated with outcome after 3 or 12 months. The population had no considerable neck trouble prior to the whiplash injury and the non-traumatic findings represent findings to be expected in the background population. Trauma-related MRI findings are rare in a whiplash population screened for serious injuries in the emergency unit and not related to a specific symptomatology. Also, pre-existing degeneration is not associated with prognosis.

show abstract

“…To explain the wide variety of symptoms, without clear objective findings, their long-lasting character as well as varying prevalence of chronic WAD in different cultures it has been necessary to take a biopsychosocial perspective on the disorder, suggesting that symptoms arise from and are modulated by pathology, psychological factors, and social context [18,28]. Some authors have perceived the condition as a chronic pain condition [27,28,33,34] based on the injury to the neck and surrounding structures, while others suggest that chronic WAD should be considered a functional somatic syndrome.…”

Section: Introductionmentioning

confidence: 99%

Symptom profile of persons self-reporting whiplash: a Norwegian population-based study (HUNT 2)

2009

View full text Add to dashboard Cite

The aetiology of chronic whiplash associated disorder (WAD) is unclear and the condition has been perceived both as a chronic pain disorder, based on the injury to the neck, and as a functional somatic disorder. Based on the hypothesis that chronic WAD should be perceived as a functional somatic syndrome, we compared the symptom profile of persons with chronic WAD with the profile of persons with a functional somatic disorder, and with the profile of persons with an organic pain disorder. A sample of 55,046 persons participating in a Norwegian population-based health study (HUNT 2) was divided into four study groups: chronic WAD, fibromyalgia, rheumatoid arthritis, and controls (none of these disorders). Symptoms were categorized as pain and stiffness, cardiopulmonary and gastrointestinal symptoms, and mental disorders. Odds ratios (ORs) with 95% confidence intervals (CIs) from logistic regression were used to compare the prevalence of symptoms among the groups. The chronic WAD group had a significantly higher prevalence of symptoms from all body parts, across organ systems and also mental symptoms, compared to the control group. The fibromyalgia group had an even higher prevalence of all symptoms, while the rheumatoid arthritis group showed an increase in the prevalence of particularly pain and stiffness symptoms and also a minor increase in the prevalence of other symptoms compared to the control group. We conclude that this study provide evidence in favour of the hypothesis that chronic WAD should be perceived as a functional somatic syndrome. Persons with chronic WAD had a symptom profile more similar to people with a functional somatic disorder than an organic pain disorder, consisting of a wide array of symptoms, not only predominantly pain symptoms.

show abstract

NOSOLOGICAL ENTITIES?: The late whiplash syndrome: a biopsychosocial approach

Cited by 111 publications

References 21 publications

Temperament and character: prognostic factors in whiplash patients?

Temperament and character: prognostic factors in whiplash patients?

Are early MRI findings correlated with long-lasting symptoms following whiplash injury? A prospective trial with 1-year follow-up

Symptom profile of persons self-reporting whiplash: a Norwegian population-based study (HUNT 2)

Contact Info

Product

Resources

About