CAN WHIPLASH CLAIMANTS BE PREDICTED AND DOES IT AFFECT THEIR OUTCOME?

Abstract

The purpose of the study and background: The effect a claim for whiplash has on somatic symptoms, psychological state and prognosis is very complex. The severity of the injury predicts both the prognosis and the likelihood of suing. The use of psychological tests to predict prognosis is controversial and they have never been used to predict those who will claim or if they change after settlement.

The methods and the results: This prospective study recruited patients attending the Accident and Emergency department. All were reviewed one week following their injury. Accident data, Visual Analogue Score (VAS), Distress Risk Assessment Method ((DRAM – modified Zung Depression Index (MZDI) and Modified Somatic Perception Questionnaire(MSPQ)) and clinical findings were recorded. At 2 years follow-up a further postal questionnaire was sent including a VAS, MZDI, MSPQ and whether or not they had recovered and /or made a claim. We reviewed 57 patients with a mean follow-up of 31 months. Ten patients were lost to follow-up, 35 made a claim and 12 did not. All claims had been settled at review. 24/35 who claimed fully recovered compared to 5/12 who did not. Initially, the mean VAS in the claimants was 5.8 compared to 3.6 in the non-claimants. The MZDI and MSPQ were 31 and 11 and 13 and 8 respectively. Post-claim the VAS was 2.6 and 1.4, the MZDI 20 and 13 and the MSPQ 7 and 2.

Conclusion: The DRAM is a good predictor of claimants and shows they are an ‘at risk’ group. The outcome is not affected by claiming.