Use of the label "litigation neurosis" in patients with somatoform pain disorder.
The use of the term "litigation neurosis"--a condition with controversial clinical significance--might correspond to the expression for a difficult physician-patient relationship. The characteristics of patients with a DSM-III-R diagnosis of somatoform pain disorder who had been labeled "litigation neurosis" by their physicians were explored. Among 74 patients referred to a pain clinic, 30% had been labeled litigation neurosis, and among 81 patients referred while claiming disability benefits, 19% had been thus categorized. The attribution of this label was neither correlated to actually being involved in a claim for disability benefits nor to involvement in legal action. Patients who had been designated with litigation neurosis were characterized by a lower educational level, a higher rate of DSM-III-R major depression, and a much higher frequency of personality disorders than patients who were not thus labeled. We postulate that the communication style of patients with this constellation of characteristics, in particular the presence of psychiatric comorbidity, may have engendered a difficult doctor-patient relationship, leading physicians to use the label in the absence of objective evidence of litigation or involvement in legal action. We agree that the inappropriate use of labels such as "litigation neurosis" should be questioned.
Allaz
A F
AF
Division of Liaison Psychiatry, University Hospital, Geneva, Switzerland.
Vannotti
M
M
Desmeules
J
J
Piguet
V
V
Celik
Y
Y
Pyroth
O
O
Guez
P
P
Dayer
P
P
D000328:Adult; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D002908:Chronic Disease; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009497:Neurotic Disorders / Q000145:classification*; D010146:Pain / Q000145:classification / Q000453:epidemiology / Q000523:psychology; D010554:Personality Disorders / Q000453:epidemiology; D010817:Physician-Patient Relations; D015995:Prevalence; D012959:Socioeconomic Factors; D013001:Somatoform Disorders / Q000145:classification / Q000453:epidemiology / Q000523:psychology; D013557:Switzerland / Q000453:epidemiology; D009626:Terminology as Topic