Accident Neurosis: Whatever Happened to Male Hysteria?

Abstract

The role of the Workmen's Compensation Board in establishing the extent to which a disability is due to an accident, and then allocating compensation has, for half a century, been carried out with fairness and skill. However, when it comes to cases of psychiatric disability the guidelines for judging causation and assigning compensation are somewhat simplistic and inadequate. The purpose of this study was to establish more accurate and reliable criteria to assist clinicians and medicolegal experts in assessing and compensating the person with a psychiatric disability. The material studied in the present pilot project comprises 50 cases referred to the author for psychiatric consultation from the year 1967 to 1971. In terms of socioeconomic background and clinical features these findings are similar to those reported in the literature, including an outstanding prevalence of hysterical symptoms. Correlation analysis between the pre-accident and accident variables and the post-accident variables or psychiatric impairment were most significant for variables related to the circumstances of the accident (type of accident, psychological threat posed by the accident). This study has permitted clarification of a number of conceptual and methodological problems, and recommendations are given for a prospective comprehensive research project on accident neurosis.