Abstract
Objective
To investigate the relation between mental health and disability after 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
Not applicable.
Participants
Claimants (N=382) within a common-law, fault-based compulsory third-party motor accident
insurance scheme in Queensland, Australia, consented to participate when invited and
were approached at each wave. Retention was high (65%) at 2-year follow-up. Disability
scores from at least 1 wave were known for 363 participants, with the mean age of
participants being 48.4 years and 62% being women.
Interventions
Not applicable.
Main Outcome Measure
Self-reported disability (via the World Health Organization Disability Assessment
Schedule 2).
Results
Participants reported higher disability (mean, 10.9±9.3) compared with the Australian
norms (mean, 3.1±5.3). A multilevel regression analysis found that 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 relation
between age and disability such that older age predicted higher disability in the
PTSD group only, whereas anxiety moderated the relation between expectation to return
to work and disability such that those with low expectations and anxiety reported
significantly higher disability.
Conclusions
Claimants with predominantly minor physical injuries report high disability, particularly
when comorbid 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
after an RTC is necessary for informing policy and practice in injury management and
postinjury rehabilitation.
Keywords
List of abbreviations:
AIS (Abbreviated Injury Scale), CI (confidence interval), GAD (generalized anxiety disorder), ISS (injury severity score), MDE (major depressive episode), PTSD (posttraumatic stress disorder), RTC (road traffic crash), UQ SuPPORT (The University of Queensland Study of Physical and Psychological Outcomes for claimants with predominantly minor injuries following a Road Traffic crash), WHO-DAS-II (World Health Organization Disability Assessment Schedule 2)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 25, 2014
Footnotes
Supported by the Motor Accident Insurance Commission; however, the views presented in this article do not necessarily reflect those of the funder.
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
