Sex Differences in Patients with Chronic Pain Following Whiplash Injury

Chronic whiplash-associated disorders (chronic WAD) cover a wide range of clinical manifestations that can occur after a whiplash injury. Women have a greater risk of developing chronic WAD, and it is suggested that psychosocial factors are related to long-term pain and functioning following whiplash injury and persistence of chronic pain. This leads to the question whether there are sex differences in psychosocial factors in chronic WAD. This study investigated 117 subjects who had experienced a whiplash injury at least 3 months before the start of the study (mean duration of pain: 67.29±63.86 months, range: 297 months). They were selected as chronically symptomatic, by excluding those who had recovered from their whiplash injury. Psychosocial aspects (including depression, fear, somatization, social support, and personality traits) were evaluated by validated questionnaires, and sex differences were tested using a univariate analysis of variance (ANCOVA), with age and time from whiplash injury as covariates. No differences in depression, fear, somatization, discrepancy in social support personality trait, Neck Disability Index scores, physical functioning, bodily pain, or general health were evident between women and men with chronic WAD. Women with chronic WAD reported higher levels of emotional support in problem situations and social companionship.

Except for emotional support in problem situations and social companionship, psychosocial factors do not vary between men and women with chronic WAD. These findings suggest little to no risk for sex bias in studies investigating psychosocial issues in patients with chronic WAD.