• A Feinstein, D Ouchterlony, J Somerville, and A Jardine.
• Sunnybrook Hospital and University of Toronto, Ontario, Canada.
• Med Sci Law. 2001 Apr 1; 41 (2): 116-21.

ObjectiveTo prospectively assess the association between litigation and neurobehavioural symptoms following mild Traumatic Brain Injury (TBI).Designa prospective study with the inception cohort assessed on average 42.2(17.2) days after injury.Settingan outpatient clinic within a large general hospital.Patientsa consecutive sample of 100 clinic attenders with mild TBI.Outcome MeasuresA cognitive screen (Mini-Mental State Examination (MMSE), Galveston Orientation and Amnesia Test (GOAT), a measure of psychological distress (the 28 item General Health Questionnaire (GHQ)) and two head injury outcome measures, the Glasgow Outcome Scale (GOS) and the Rivermead Head Injury Follow-up Questionnaire (RHFUQ).ResultsDemographic characteristics, TBI severity ratings and premorbid risk factors for poor outcome did not differ between litigants (27.8 per cent of the sample) and non-litigants. However, litigants were significantly more anxious (p<0.0001), depressed (p<0.01), had greater social dysfunction (p<0.0001) and had poorer outcome on the GOS (p<0.002) and RHFUQ (p<0.002). There were no cognitive differences between the groups.Conclusionsthe data demonstrate an association between litigation and increased psychological distress at the outset of the litigation process. While association is not synonymous with causality, the absence of demographic, premorbid and TBI related differences between litigants and non-litigants suggests that the pursuit of compensation may influence the subjective expression of symptoms following mild traumatic brain injury.

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