Psychopathology associated with motor vehicle crashes

Trauma is a leading cause of morbidity and mortality in the Western world and motor vehicle crashes (MVC) are one of the major contributors. The economic costs are huge, for instance, in Australia during 2003, road related crashes amounted to around $17b or 2.3% of the Australian Gross Domestic Product. MVCs also impose a very substantial health impact often involving mild to very serious injury with possible substantial long-term disability resulting. The most prevalent examples include catastrophic injuries such as severe traumatic brain injury and spinal cord injury. While catastrophic injuries are devastating, they are infrequent. Non catastrophic injuries however, are common following an MVC. These include musculoskeletal injuries, which are injuries to the bones, joints, muscles, tendons, ligaments, or nerves. Common examples of a musculoskeletal injury arising from road crashes are whiplash or lower back injury. Chronic pain is prevalent. Psychological injury following an MVC is believed to be common, with research suggesting over 40% of people surviving an MVC report significant levels of psychological distress, compared to for instance, just less than 20% of those surviving a bushfire. As time passes, risk of psychopathology increases. For example, after 6 months, depression occurs in over 40% of MVC adult victims, while post-traumatic stress disorder has been estimated to occur in over 20%. This Chapter will present a systematic review of the occurrence of psychopathology following an MVC, including prevalence of psychological disorders, factors that predispose a person to psychopathology, and the influence of compensation on psychopathology. Finally, the classification of psychopathology arising from an MVC will be reviewed in the light of current psychiatric classification systems such as the Diagnostic and Statistical Manual of Mental Disorders. Implications for an improved classification of psychological injury following an MVC will be discussed. © Nova Scicence Publishers, Inc. All rights reserved