Posttraumatic amnesia, post-concussional symptoms and accident neurosis.

This communication surveys 398 consecutive head injury patients who were in regular full-time employment at the time of injury and who were examined in connection with a claim for compensation. In uncomplicated cases there was a close correlation between the duration of posttraumatic amnesia and the length of time off work. Some common causes of prolonged organic disability are mentioned. The recovery rate of patients suffering from posttraumatic emotional disorders, such as depression or anxiety, was proportional to the initial severity of injury, whereas the indefinite invalidism associated with so-called 'accident neurosis' was found to be rare in severely injured patients. 'Accident neurosis' also was more common in manual workers sustaining accidents at work than in the same occupation group after road accidents, or in non-manual workers. It is concluded that posttraumatic emotional disorder and 'accident neurosis' are not the extremes of a spectrum but separate and distinguishable conditions.