Association Between Symptoms and Health Outcomes in Chronic Whiplash-Associated Disorders: a Series of Mediation Analyses.

OBJECTIVE

The purpose of this study was to investigate the relationship between symptoms across body systems and health outcomes in individuals with chronic whiplash-associated disorders (WADs).

METHODS

A cross-sectional study was conducted at a multidisciplinary chronic pain center in Calgary, Canada, between October 2019 and December 2021. Participants with a history of WAD completed questionnaires assessing pre-existing symptoms across bodily systems and related health outcomes. Mediation analyses evaluated the associations between symptom profiles and health outcomes, as well the role of pain cognitions.

RESULTS

Of 305 participants in the registry database, 238 were eligible. The majority reported symptoms from 2 or more body systems, especially neurological, gastrointestinal, and psychological symptoms. Participants demonstrated moderate-to-severe pain and disability, with low physical health-related quality of life. While multiple symptoms correlated with worse health outcomes, mediation analyses revealed pain cognitions primarily influenced these associations, except for eye-related symptoms, which directly correlated with pain and disability.

CONCLUSION

The study highlights that chronic WAD is characterized by a complex symptom profile across various bodily systems. Although a broader symptom profile is linked to poorer health outcomes, the effects are often mediated by pain cognitions. Notably, prior health conditions did not adversely impact outcomes, suggesting a need for targeted interventions focusing on cognitive aspects in patients with chronic WAD.