Abstract
The nature and prognosis of psychoneurotic disorders following accidental injury have long been a source of argument. The present authors have endeavoured to follow up and classify 82 subjects referred by solicitors for psychiatric evaluation following injury.
The subsequent progress of 71 (87%) of the original consecutive sample was successfully obtained. Approximately one-third of the group were disabled by neurotic symptoms which appeared to result from the emotional stress of the accident itself and were thus classified as suffering from true “traumatic neurosis”. These patients improved with the passage of time. About one-half of the group were thought to be unconsciously motivated by the possibility of financial compensation and these patients failed to improve or became worse up until the time of settlement of their claims. The sample also included 5 (6%) frank malingerers; the subjects with “compensation neurosis” invariably denied concern over the outcome of their lawsuits.
Only two of the group received psychiatric treatment following termination of their litigation and only one able-bodied worker was known not to have returned to work by the end of the study. The need for early recognition of the fact that a neurotic disorder is being perpetuated by secondary gain factors is stressed.