USE OF THE LABEL LITIGATION NEUROSIS IN PATIENTS WITH SOMATOFORM PAINDISORDER

The use of the term ''litigation neurosis''-a condition with controver sial clinical significance-might correspond to the expression for a di fficult physical-patient relationship. The characteristics of patients with a DSM-III-X diagnosis of somatoform pain disorder who had been l abeled ''litigation neurosis'' by their physicians were explored. Amon g 74 patients referred to a pain clinic, 30% had been labeled litigati on neurosis, and among 81 patients referred while claiming disability benefits, 19% had been thus categorized. The attribution of this label Teas neither correlated to actually being involved ill a claim for di sability benefits nor to involvement in legal action. Patients who had been designated with litigation neurosis were characterized by a lowe r educational level, a higher rate of DSM-III-R major depression, and a much higher frequency of personality disorders than patients who wer e not thus labeled. We postulate that the communication style of patie nts with this constellation of characteristics, in particular the pres ence of psychiatric comorbidity, may have engendered a difficult docto r-patient relationship, leading physicians to use the label ill the ab sence of objective evidence of litigation or involvement in legal acti on. We agree that the inappropriate use of labels such as ''litigation neurosis'' should be questioned. (C) 1998 Elsevier Science Inc.