This chapter begins with a critical review of the available evidence about the psychiatric effects of road accidents, then considers the psychiatric complications that may arise. It also discusses the special issue of compensation, and considers their implications for clinical care, road safety, and the law. Sources of evidence include general evidence on reactions to life events and physical illness, trauma research in general, prospective and other accident studies, medico-legal experience, and pre-accident psychiatric disorder. Very few satisfactory studies have concentrated on representative samples of survivors. The psychiatric consequences of road accidents include cognitive, acute, emotional, and post-traumatic stress disorders, travel anxiety, alcohol problems, anger, and worry about disfigurement. The psychiatric and psychological consequences of road accidents need to be viewed in the wider context of changes in quality of life, and sometimes last for over five years. One study suggests that psychiatric complications affect nearly 50% of children involved in accidents. A high proportion of 'innocent' victims of accidents seek compensation. The widely held belief that whiplash neck injury patients are neurotic and motivated by desire for compensation is wrong and harmful.
Abstract