Personality disorders are not associated with nonrecovery in patients with traffic-related minor musculoskeletal injuries.
BACKGROUND
Personality disorders (PDs) have been suggested to be one of the determinants that might influence recovery after injuries but has rarely been measured. This study describes the occurrence of PDs among patients with minor traffic-related musculoskeletal injuries and relates these disorders to nonrecovery 12 months after the injury.


METHODS
This is a single-center, prospective, cohort study. We included patients with minor traffic-related musculoskeletal injuries at a general hospital in Stockholm, Sweden, with a catchment area of 0.6 million people. Structured Clinical Interview II screen questionnaire was used to measure PD. Outcome measure were self-reported recovery at 12 months (yes/no).


RESULTS
Fifty-one percent of all patients (102 of 200) had at least one PD, and 20% had at least two. The proportion of nonrecovered was 50% (51 of 102) among those with one or more PD compared with 39% (38 of 98) among those without any PD (p = 0.12). Patients with a Cluster A (paranoid, schizoid, and schitzotypal) or Cluster B (borderline, histrionic, narcissistic, and antisocial) PD were associated with nonrecovery. When compared with patients without any PD, patients with a Cluster A or Cluster B PD had an increased risk of nonrecovery (OR: 2.5; 95% CI: 1.0 -5.9 and OR: 2.1; 95% CI: 1.2-3.8, respectively). However, after adjusting for mental health factors at the time of the injury, these associations were no longer significant.


CONCLUSIONS
PDs are common among patients with minor traffic-related musculoskeletal injuries. Our study does not support the view that PDs are associated with nonrecovery. The patient's mental health status at the time of the crash seems to be more important for nonrecovery than a PD.
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, S-118 83 Stockholm, Sweden. carin.ottosson@sodersjukhuset.se
Carin
C
Ottosson
Hans
H
Pettersson
Bo
B
Bergman
Sari
S
Ponzer
D000063:Accidents, Traffic / Q000523:psychology*; D000328:Adult; D001008:Anxiety Disorders / Q000150:complications; D001294:Attitude to Health; D003866:Depressive Disorder / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D009141:Musculoskeletal System / Q000293:injuries*; D010554:Personality Disorders / Q000175:diagnosis* / Q000523:psychology; D020127:Recovery of Function; D012803:Sick Role; D011795:Surveys and Questionnaires; D014911:Whiplash Injuries / Q000523:psychology