PCS, Iatrogenic Symptoms, and Malingering Following Concussion
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- Bender, S.D. & Matusewicz, M. Psychol. Inj. and Law (2013) 6: 113. doi:10.1007/s12207-013-9156-9
In postconcussive syndrome (PCS), subjective experience of symptoms seems to surpass objective evidence of those symptoms. For many years, clinicians and researchers have suspected both neurologic and psychologic forces in PCS. While the neurologic symptoms tend to resolve, psychological factors appear to have a more complex and difficult to characterize course. We argue in this paper that this complexity leads to diagnostic problems when considering PCS. We review several difficulties with current nosology regarding PCS and related conditions, as well as the inter-related and complicating roles of iatrogenic factors and malingering. We conclude that PCS is of insufficient diagnostic specificity and that it is prone to misdiagnosis, even causing new and possibly unrelated symptoms to develop in some cases. Further research on PCS and the factors that affect its course is needed.