Use of the label "litigation neurosis" in patients with somatoform pain disorder

Article Article scientifique Article Use of the label "litigation neurosis" in patients with somatoform pain disorder eng 1998 author Allaz Anne-Françoise 126689 author Vannotti M author Desmeules Jules Alexandre 73542 author Piguet Valérie 64458 author Celik Massas Yasemin 103464 author Pyroth O author Guez P author Dayer Pierre 25460 91-97 10.1016/s0163-8343(97)00127-8 9582593 0163-8343 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. Adult Attitude of Health Personnel Chi-Square Distribution Chronic Disease Comorbidity Disability Evaluation Female Humans Male Middle Aged Neurotic Disorders/classification Pain/classification/epidemiology/psychology Personality Disorders/epidemiology Physician-Patient Relations Prevalence Socioeconomic Factors Somatoform Disorders/classification/epidemiology/psychology Switzerland/epidemiology Terminology as Topic Dewey 617 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 302 Groupe Desmeules Jules (pharmacologie/toxicologie) 567 General hospital psychiatry 20 2 0e80dc3c-1000-46df-97e0-4952a1376bf2 Article (Published version) Public 1-s2.0-S0163834397001278-main.pdf 216658 application/pdf openAccess Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Use of the label "litigation neurosis" in patients with somatoform pain disorder	General hospital psychiatry			1998	474	219

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Celik Massas, Yasemin