Psychiatric morbidity following motor vehicle accidents: A review of methodological issues

doi:10.1016/S0010-440X(98)90069-4

Comprehensive Psychiatry

Volume 39, Issue 3, May–June 1998, Pages 111-121

https://doi.org/10.1016/S0010-440X(98)90069-4 Get rights and content

Abstract

Motor vehicle accidents (MVAs), even those of a nonserious nature, appear to increase the risk of severe psychiatric morbidity in survivors. The present review examines the evidence indicating the levels of psychiatric morbidity in MVA survivors. Although no consistent profile has emerged, the most commonly reported symptoms are depression, anxiety, irritability, driving phobia, anger, sleep disturbances, and headache, with rates of posttraumatic stress disorder (PTSD) across studies of 0% to 100%. Variability in the type and severity of psychiatric outcomes may be due, in part, to methodological inadequacies in many studies, particularly the use of biased population samples, inclusion of subjects exposed to varied types of accidents, an absence of a clear definition of PTSD, a reliance on clinical judgment rather than the use of objective psychometric measures, the failure to include ratings of injury severity, and the absence of assessments for past exposure to traumatic events or preexisting posttraumatic reactions. The most important concern relates to the use of nonrepresentative samples, usually patients referred for medicolegal assessment in whom issues of compensation are of central importance. Gender and age differences distinguish the compensation group from the general population of MVA survivors, who therefore may also differ in the vulnerability to posttraumatic morbidity. It is argued that more systematic research on unselected subject samples is critical to establish epidemiological data on the true nature and extent of psychiatric morbidity following MVAs.

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^☆: Supported by the National Health and Medical Research Council of Australia, and the Motor Accidents Authority of New South Wales.

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Psychiatric morbidity following motor vehicle accidents: A review of methodological issues☆

Abstract

Behav Res Ther

J Anxiety Disord

Aust J Public Health

Behav Res Ther

Clin Psychol Rev

Behav Res Ther

Behav Res Ther

Behav Res Ther

Accid Anal Prev

Accid Anal Prev

Accid Anal Prev

Accid Anal Prev

Accid Anal Prev

Accid Anal Prev

Accid Anal Prev

Accid Anal Prev

Psychosomatics

Trauma studies. I. Metropolitan Sydney Trauma Data

Med J Aust

South Western Sydney Regional Trauma Registry Report 1994/1996

Road Fatalities Australia; 1996 Statistical Summary

Victims of traffic accidents: incidences and prevention of post traumatic stress disorder

J Clin Psychol

Psychiatric consequences of road traffic accidents

BMJ

Psychiatric morbidity associated with motor vehicle accidents

J Nerv M Dis

Post Traumatic Neurosis: From Railway Spine to Whiplash

Twenty years of trauma: psychological abstracts 1970 through 1989

J Trauma Stress

Psychiatric disorders following mad traffic and industrial injuries

Aust NZJ Psychiatry

Accident litigants with neurotic symptoms

Med J Aust

Vehicle drivers and fatal accidents

Suicide Life Threat Behav

The post accident syndrome: variations in the clinical picture

Aust NZ J Psychiatry

The long term psychiatric consequences of accidental injury: a longitudinal study of 107 adults

Br J Psychiatry

A typology of psychiatric reactions to motor vehicle accidents

Psychopathology

Undiagnosed post traumatic stress disorder following motor vehicle accidents

Med J Aust

The Detection of Psychiatric Illness by Questionnaire

Impact of Event Scale: a measure of subjective stress

Psychosom Med