Author Affiliations: Dr Stein is Professor of Psychiatry In-Residence and Director, Anxiety Disorders Program, Department of Psychiatry, University of California, San Diego; and Chief, Anxiety & Traumatic Stress Disorders Clinic, San Diego Veterans Affairs Medical Center.
Clinical Crossroads Section Editor: Margaret A. Winker, MD, Deputy Editor.
DR SHIP: Mr M is a 46-year-old man who has
experienced physical and emotional symptoms following a recent motor vehicle
collision. He lives with his wife near Boston and works as an artist. He has
managed care insurance.
Mr M's history includes 3 unrelated motor vehicle collisions. The first
occurred overseas in December 1999. At that time, he was a backseat passenger
in a taxicab struck by another vehicle. He had a thoracic compression fracture
and required a prolonged course of rehabilitation. He recovered from this
event except for some back and neck spasms. In June 2001, Mr M was a belted
driver when his car was rear-ended. His neck and back pain and spasms returned,
and he returned to physical therapy. In late January 2002, he was a belted
front-seat passenger in a car struck head-on by another vehicle. The air bag
deployed. He sustained 3 fractured ribs and multiple contusions; his back
and neck pain returned.
Stein MB. A 46-Year-Old Man With Anxiety and Nightmares After a Motor Vehicle Collision. JAMA. 2002;288(12):1513-1521. doi:10.1001/jama.288.12.1513