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Chronic Whiplash Syndrome as a Functional Disorder
Henry Berry, MD, DPsych, MRCP(Lond), FRCPC
Arch Neurol. 2000;57:592-594.
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IT IS A CONTRADICTION that neck strain caused by a rear-end car collision may leave the victim with chronic symptoms and disability, whereas the comparable jolting and neck strain of the offending driver or in the context of a sport1 will cause no lasting symptoms. Is this the reaction of a susceptible patient to a painful injury for which someone is responsible and who, entangled in the adversary system, is examined repeatedly, overtreated, and subjected to the negative effects and disincentives of secondary gain and the illness role? Or is it simply the result of injury to the neck, inner ear, brain, or other structures that newer and more sensitive investigations eventually will demonstrate?
These questions illustrate 2 opposite approaches, the behavioral and the physical, to the analysis of a problematic clinical condition. By the canons of science, it is methodologically correct to combine . . . [Full Text of this Article]
From the Department of Neurology, St Michael's Hospital, and Faculty of Medicine, University of Toronto, Toronto, Ontario.
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