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A blind spot for secondary gain affecting therapy outcomes

Published online by Cambridge University Press:  16 April 2020

J. van Egmond  and
I. Kummeling
J. van Egmond*
Affiliation:
Psychiatric Hospital Brinkgreven, Deventer, The Netherlands
I. Kummeling
Affiliation:
Psychiatric Hospital Brinkgreven, Deventer, The Netherlands
*
*Correspondence and reprints: Polikliniek Hanzepoort, Pikeursbaan 3, 7411 GT Deventer, The Netherlands. E-mail address: [email protected] (J. van Egmond).
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Summary

Background

A study to determine whether the expectation for secondary gain held by psychiatric outpatients was associated with therapy outcomes.

Methods

The study was conducted at a Dutch psychiatric outpatient department. Our investigation set out to explore the expectation of obtaining secondary gain by directly asking the patient and clinician via questionnaires whether the patient anticipated to get specific ‘benefits’ from being in therapy.

Results

From 166 patients, 70 (42.2%) reported to expect secondary gain while in therapy. We found a significant relation between expectation for secondary gain and treatment outcomes. Patients with expectations for secondary gain were significantly more prone to poor therapy outcome. Only in nine of 147 cases (6%) did patients explicitly express their expectations for secondary gain towards a psychiatrist. Moreover, expectations for secondary gain did not appear to be related to Axis I and Axis II diagnoses.

Discussion

Secondary gain appeared to be a ‘veiled motive’ for getting therapy: patients did not express their expectations for secondary gain explicitly towards a psychiatrist. This aspect of veiled motives is of particular relevance in regard to the fact that expectations for secondary gain appeared to affect therapy results.

Keywords

secondary gaintherapy outcomesulterior motives
Type
Original article
Information
European Psychiatry , Volume 17 , Issue 1 , March 2002 , pp. 46 - 54
Copyright
Copyright © Éditions scientifiques et médicales Elsevier SAS. 2002

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References

Barksy, AJKlerman, GLOverview: hypochondriasis, bodily complaints, and somatic styles. Am J Psychiatry 1983; 140; 273–83.Google Scholar
Binder, LMRohling, MLMoney matters: a meta-analytic review of the effects of financial incentives on recovery after closed-head injury. Am J Psychiatry 1996; 153; 7–10.Google ScholarPubMed
Cassidy, JDCarroll, LJCôté, PLemstra, MBerglund, ANygren, AEffect of eliminating compensation for pain and suffering on the outcome of insurance claims. N Engl J Med 2000; 342; 1179–86.CrossRefGoogle ScholarPubMed
Craig, TKJDrake, HMills, KBoardman, APThe South London somatisation study II. Influence of stressful live events, and secondary gain. Br J Psychiatry 1994; 165; 248–58.CrossRefGoogle Scholar
Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: American Psychiatric Association; 1980.Google Scholar
Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association; 1994.Google Scholar
Dansak, DASecondary gain in long-term hemodialysis patients. Am J Psychiatry 1972; 129; 128–31.CrossRefGoogle ScholarPubMed
Elkayam, OBen Itzhak, SAvrahami, EMeidan, YDoron, NEldar, Iet al. Multidisciplinary approach to chronic back pain: prognostic elements of the outcome. Clin Exp Rheumatol 1996; 14; 281–8.Google ScholarPubMed
Ferguson, EHypochondriacal concerns, symptom reporting and secondary gain mechanisms. Br J Med Psychol 1998; 71; 281–95.CrossRefGoogle ScholarPubMed
Fisbain, DASecondary gain concept. Definition, problems and its abuse in medical practice. APS Journal 1994; 3; 264–73.Google Scholar
Fisbain, DASecondary gain concept: a review of the scientific evidence. Clin J Pain 1995; 11; 6–21.CrossRefGoogle Scholar
Frieman, BGFenlin, JMAnterio acromioplasty: effect of litigation and workers' compensation. J Shoulder Elbow Surg 1995; 4; 175–81.CrossRefGoogle Scholar
Gianoli, GMcWilliams, SSoileau, JBelafsky, PPosturographic performance in patients with the potential for secondary gain. Otolaryngol Head Neck Surg 2000; 122; 11–8.CrossRefGoogle ScholarPubMed
Hawkins, KAThe importance of employing objective malingering detection methods when secondary gain potential exists. NNBN 1994; 7; 118–21.Google Scholar
Mendelson, GThe effect of compensation and litigation on disability following compensable injuries. Am J Forensic Psychiatry 1983; 4; 97–112.Google Scholar
Powel, DHLessons learned from therapeutic failure. J Psychother Integr 1995; 5; 175–81.CrossRefGoogle Scholar
Schoen, MResistance to health: When the mind interferes with the desire to become well. Am J Clin Hypnosis 1993; 36; 47–54.CrossRefGoogle ScholarPubMed
Young, JNShaffrey, CILaws, ERLovell, LRLumbar disc surgery in a fixed compensation population: a modal for influence of secondary gain on surgical outcome. Surg Neurol 1997; 48; 552–9.CrossRefGoogle Scholar
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