Fibromyalia is one of several "diagnoses" that concern many of us who have examined such patients and their families. A conference on this subject was reported in the May, 2000, issue of the Journal of Rheumatology. Nine years of litigation over putative fibromyalgia said to be caused by a minor accident has yielded little satisfaction for any participants in the conference. One side insisted it is quite real; the other side stating that it exists to bolster legal claims and compensation. The Comprehensive Pain Program in Toronto, Ontario, Canada report on the experience of a family of six who began to report similar symptoms following consultation with a lawyer 5 months after a minor rear-end motor vehicle accident. Seven years after the accident, a "noted expert in chronic pain" diagnosed the entire family with fibromyalgia. That expert attributed the delayed onset of symptoms to fibromyalgia, ...
Among injured workers, is PTSD more common in males? Being exposed to a traumatic event can have serious psychological consequences for anyone, but women have a greater risk of developing post-traumatic stress disorder (PTSD) after an assault than men do. They have about the same risk as men when it came to coping with a trauma that did not involve assault, according to a recent study. Experiencing such a trauma is more common than most people think. Nearly 80% of people in a Canadian community reported that they had been exposed to a serious traumatic event in their lifetimes. One of the interesting things is that, even in peacetime United States and Canada, the likelihood that any of us will be exposed to at least one traumatic event in our lifetime is very high. Another important thing we learn from this study is that women are at greater risk of developing PTSD following an assaultive trauma situation, whether it's a sexual or nonsexual ...
Dysthymic Disorder can only be diagnosed after an injured employee has been depressed for ~2 years. Major Depression is more frequently diagnosed after injury than this Dysthymic Disorder. Which is worse? Dysthymic (pronounced: diss-thy-mick) Disorder consists of waxing and waning depressive symptoms spanning a two year period. If a person has a situational depression as a result of an event in the past six months, it is called “Adjustment Disorder with Depressed Mood” and most often subsides as the event becomes further in the past. While the word MAJOR in Major Depressive Disorder sounds significant, those with a major depressive episode often recover quickly and may not be disabled by their symptoms. During the course of a recent study, the patients with dysthymic disorder had more symptoms, functioned worse, and were significantly more likely to attempt suicide and be hospitalized than were patients with episodic major ...
I have had injured workers who complain of severe headaches and say they cannot work. Often these individuals have had no head injury. The neurologists seem to feel the headaches are disabling. There is an article in the journal Headache with a lengthy discuss of depression and anxiety as being among the psychological symptoms that accompany frequent headache and headache-associated disability. The presence of psychological comorbidity (that is, concurrent anxiety and depression as well as headache) with headache predicts a longer lifetime duration of headache and a poorer prognosis for headache reduction. Subjects who had headaches more than 4 days a week and those with headache-associated activity limitation for 3 or more days a week showed significantly greater depression and anxiety. Anxiety and depression were not believed to result from or cause the headaches but to co-exist in many headache sufferers. ...
I have found that when an injured worker claims to have psychological problems as a result of physical injury, they often then are not compliant with a psychological referral. There are those patients for whom domestic violence may be the main issue. This violence can arise from substance abuse after injury and/or frustration in dealing with pain. The pattern goes as follows: There is a violent outburst. The patient (chiefly male) then asks their case manager, adjustor or primary provider for a psychological referral. The referral is made, The abused spouse feels "reassured" that the injured worker is no longer violent. The pressure/urgency for the appointment is removed, and the patient then fails to show. Most people are not skilled at identifying domestic violence. Recent research indicates that even after 3 hours ...
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