Long-Term Outcome of Motor Vehicle Accidents

This current study¹ is a 5-year follow-up of a group of accident patients from a 1-year follow-up study² published in 1993. In that original study, the researchers found a strong relationship between psychological symptoms and physical pain—a relationship that has recently gotten more attention in the literature.

This updated study questioned 111 patients about their demographics, social adjustment, mental state, psychological status, post-traumatic stress disorder (PTSD) symptoms, medical conditions, quality of life, and driving habits. The group of 111 consisted of three separate groups of patients: 34 whiplash patients; 37 car occupants; and 40 motorbike riders.

The findings are summarized as follows:

"The whiplash subjects had the best physical outcome and they reported few effects on leisure and work than the other groups." At five years after the accident, 32% of the whiplash patients reported minor and 3% reported major physical problems, and 23% reported diminished leisure enjoyment.
Although the whiplash patients showed better improvement on these two measures, they were statistically similar on all other measures—including the occurrence of PTSD symptoms.
Eight patients had a delayed onset of PTSD identified five years after the accident.
Of the 34 whiplash patients, 23 (68%) were seeking compensation from the accident. 78% of these claims had settled within 3 years, and there was no active litigation at the time of the study. Still, 11% of the whiplash patients had major symptoms of travel anxiety, and 18% had symptoms of PTSD.

The authors discussed the problem of travel anxiety:

"Travel anxiety after a motor vehicle accident is largely unrecognized in clinical practice and has been seen clinically as an occasional neurotic problem that might be associated with seeking compensation. Published literature is conflicting but the present study clearly shows that concern about travel is associated with considerable distress, behavioral change, and disability that is unrelated to the progress of compensation proceedings."

And the authors also address the issue of compensation:

"The prolonged and frustrating pace of legal proceedings was the cause of very considerable anger and concern. This was especially so in those with more severe injuries (and therefore with the greatest need of compensation) whose cases generally took the longest time to resolve. Although there was no evidence that compensation was a major cause of longer term psychiatric and social problems, the prolonged and frustrating legal processes were a cause of stress and of financial difficulties and might reasonably be expected to have contributed to victims' overall views of satisfaction with outcome�Settlement did not seem to lead to any substantial change in social outcome, but it did result in subjects feeling a profound sense of relief and feeling able to move on from an unwanted preoccupation with the accident and its adverse effects on every day life and ambitions."

Mayou R, Tyndel S, Bryant B. Long-term outcome of motor vehicle accident injury. Psychosomatic Medicine 1997;59:578-584.
Mayou RA, Bryant B, Duthie R. Psychiatric consequences of road traffic accidents. British Medical Journal 1993;307:647-651.

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