The effects of litigation on symptom expression: a prospective study following mild traumatic brain injury.

Objective:To prospectively assess the association between litigation and neurobehavioural symptoms following mild Traumatic Brain Injury (TBI).Design:A prospective study with the inception cohort assessed on average 42.2(17.2) days after injury.Setting:an outpatient clinic within a large general hospital.Patients:a consecutive sample of 100 clinic attendee with mild TBI.Outcome measures:A 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).Results:Demographic 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)...