Compensation Psychosis

Extract

Kennedy (1946) stated that “A compensation neurosis is a state of mind, born out of fear, kept alive by avarice, stimulated by lawyersand curedby a verdict”. This theme, supported by Miller's influential paper in 1961, has ensured that genera tions of patients havebeenregardedwith suspicion if they daredto presentwith psychologicalsymptoms following an accident. The view remained un challenged for over a decade and is still often presentedto, and acceptedby, our Courts, despite the fact that Miller reached his conclusions after examiningpatientwsho presentefdorlegarleports in whose casesit was not surprising that he found a relationship betweencompensation and psycho logical sequelae The psychological effects of proceeding litigation on the victim of an accident remain a matter of current debate. McKinley et al (1983), reported differences betweenthose patients suffering a severeblunt headinjury claimingcompen sation and those not claiming compensation. The reports givenby relativesof changesin both patients werevery similar. However, reports given by patients themselves differed with claimants reporting slightly more symptoms than non-claimants. In a study by Whitein 1981, the author followed up 163 victims of accidents admitted to the Birmingham Accident Hospital (76 burns and 87 general accidents). One year after their accident, psychological sequelaewere found in approximately two-thirds of the group, one third being moderately-to-severely psychologically affected. There was no statistical difference between those victims in whom the accident had given rise to litigation and in whom the case was still proceeding and those victims where compensation was not an issue.