The diagnosis hang-up and cardiological manifestations of PTSD

 

Commentary

In this road traffic accident case where there was a claim for psychiatric injury, the two psychiatric experts produced between them 14 reports, including addenda and other admissible communications. The fundamental disagreement was the diagnosis: PTSD or adjustment disorder. It appears that four of the reports by the defendant’s expert were in rebuttal of the opinion of the plaintiff’s expert. This summary does not reflect the considerable extent to which the court had to analyse the evidence as to diagnosis. In the court’s judgment diagnosis hardly mattered. The judge said that more important, in his view, was the impact that the condition had on the plaintiff’s everyday functioning and lifestyle. Then when awarding damages, he said that the psychiatric damage suffered by the plaintiff attributable to the accident could be described as moderately severe whether that be under a diagnosis of post-traumatic stress disorder or psychiatric damage generally. 

Although hyper-arousal is a feature of PTSD that is often part of the evidence in psychiatric injury cases, this is, as far as I know, the first time that there has been a claim for cardiological injury. This element of the claim was not successful but the reason was that the court found no evidence of cardiac symptoms contemporaneous with the aftermath of the accident.  

Learning points:

Psychiatry and psychology

• In cases of alleged psychiatric injury, the diagnosis is not as important as the damage, in particular the impact of the condition on everyday functioning and lifestyle.

• Beware unduly focusing on a particular point and ignoring other evidence which is inconsistent with the point being made.

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