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Clinical Crossroads | Clinician's Corner

A 46-Year-Old Man With Anxiety and Nightmares After a Motor Vehicle Collision

Murray B. Stein, MD, FRCPC, Discussant
JAMA. 2002;288(12):1513-1521. doi:10.1001/jama.288.12.1513.
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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.

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