The post-accident syndrome: variations in the clinical picture.

Three hundred and twenty-seven subjects involved in civil accident litigation and referred by solicitors for either plaintiff or defendant were examined. A precise psychiatric diagnosis was applicable in only a minority of subjects, although psychiatric symptoms, including pain, anxiety and depression, were prominent. Overall the clinical picture was an amorphous one. Cluster analysis was performed to examine a variety of clinical, demographic and historical variables. This showed four stable groups, which are here described as: stoic, depressive, phobic motor accident and prior claimants. It is suggested that the phenomenological approach taken here, paying particular attention to clinical sub-groups, may be a more useful route towards the understanding and treatment of post-accident psychiatric disturbance than is the existing but confused approach, in which motivation has been a prime focus of interest. The particular sub-groups demonstrated here, if replicated, could form the basis for such an approach.