Dr. David B. Adams – Psychological Blog

Psychology of Injury, Pain, Anxiety and Depression


An increasing number of my cases are complicated by injured workers going to the internet, getting either incomplete or inaccurate data, and then attempting to coordinate their own care, including their medications. Is this a concern?

I refer to many of these patients as _cyberchondriacs._

They find a disorder or condition that somewhat resembles their symptom pattern and then they fill in the blanks. That is, while they may not have all the symptoms for the disorder, they begin to focus upon the potential for these symptoms and believe they are occurring. They then search for an _expert_ based upon their internet reading and become convinced that only a specific person or specific procedure will assist them.

They cannot easily be dissuaded.

Further, they read about all potential side effects of their medications and often refuse to take what is prescribed and/or misinterpret the response to the medication as an adverse reaction.

These patients tend to be very vulnerable to _neologisms_ (new terms) which, to them, seem to uniquely describe their condition. They then obsessively read about _X.Y.Z. Disorder_ and develop complaints that coincide with that diagnosis. Since some of these diagnoses are broad and ill-defined with flexible diagnostic boundaries, the patient can readily adapt their own symptoms to meet that diagnosis.

On the one hand, we have the patients that have not a clue as to what is wrong with them no matter how carefully or how often it is explained while on the other hand we have the competent patient who is misled by what he/she has read.

There is no simple solution. They are going to read, and they have abundant time available to do so. On-line information ranges from brilliant to dangerous. All that can be done is to insure that they are provided all reasonable and accurate data by those who are delivering care. Our greatest concern is when their reading creates hypochondriacal symptoms and/or leads them to seek ineffective or risky treatment.

Comments for this post are closed.


Fantasy: psychological problems as an add-on at the end of a case in order to grow the claim. The complaints always occur …
Read Blog Post

Corruption of the Health Care Mission

Many injuries, resulting in spinal surgery, result in four consequent events: a. There is an onset of pain and potential …
Read Blog Post

Psychological not Psychopathological

Is it not a normal response to be depressed by a significant injury? You lose fingers, or injury your back, or have a shoulder …
Read Blog Post