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A chicken and egg story: whiplash

3 February 2011 

Whiplash is known to be associated with increased levels of anxiety and depressive symptoms. This increase is generally viewed as the result of the initial accident. However, a recent paper by scientists at the Institute of Psychiatry (IoP), King’s College London, suggests that the reverse may be true; individuals with anxiety and depression are in fact at an increased risk of whiplash.

Professor of General Hospital Psychiatry at the IoP,  Matthew Hotopf, said: ‘Pain and symptoms of anxiety and depression often go hand in hand. It’s usually assumed that the pain associated with whiplash causes depression. Our study suggests that it also works the other way around – people with symptoms of anxiety and depression are more likely to gain a diagnosis of whiplash in the longer term. We do not think that this is because they are more likely to have accidents, because most whiplash accidents are caused by someone else’s mistakes. Instead we suspect that if you have anxiety or depressive symptoms at the time of an accident, you are more likely to have difficulties recovering and acute pain (which everyone will get a bit of) will be more likely to persist.

The longitudinal study assessed baseline symptoms of anxiety and depression in 37,792 volunteers, who were then followed up over 11 years. The results are part of a wider HUNT study, which is an attempt to interview and examine everyone who lives in a certain area of Norway. Not only is it very big, but because Norwegians have an identifying number, the results of the survey can be linked to national registries for mortality and disability benefits. It is one of the largest health studies ever performed.

 ‘Reverse causality in the association between whiplash and symptoms of anxiety and depression. The HUNT study.’ Published in this month’s edition of Spine. To read the paper in full, please follow the link.

To read more about the HUNT study, please follow the link.

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