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Factitious patients with fictitious 'disorders: a note on Munchausen's Syndrome
Author(s) -
Kaplan Robert
Publication year - 1992
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1992.tb139829.x
Subject(s) - munchausen syndrome , citation , factitious disorder , medicine , psychology , psychiatry , psychoanalysis , library science , computer science , medical emergency , poison control , suicide prevention , child abuse
Helmet intolerance among motorcyclists To the Editor: A recent leiter by Dr Ross Holland,' regarding the controversial topic of helmet intolerance among motorcyclists,' prompted us to re-examine our own data on helmet use and the national origin of motorcycles.' A helmet use law finally took effect in California just this month; after years of effort by physicians and other injury control advocates. We linked 'detailed data describing fatal motorcycle crashes in CalifOrnia in 1987 and 1988 (from the US National Highway Traffic Safety Administration's Fatal Accident Reponing System) with death certificates describing .the injuries sustained by fatally injured motorcyclistS. The resulting Sample included 1353 motorcyclists wi:1o were riding 1310 vehicles. Among the 73 motorcyclists w~o were killed .on Harley Davidson machines, only one was wearing a helmet:Among the 349 motorcyclists who were killed on Hondas, 241 (69%) were wearing helmets. A similar proportion of fatally injured motorcyclists riding other JaPanese or European vehicles (323 of 479, 67%) had worn helmets. Even after adjustment for other characteristics (age; alcoi:1ol intoxication; positive blood toxicoiogy; Invalid licence; speed limit; history ,of speeding, drunk driving,. Or other traffic convictions within three years; history of a motor vehicle accident within three years; and vehicle age) by logistic regression, Harley Davidson use was still associated with 33 times the odds (95% confidence interval, 4-245) of failure to wear a helmet. These findings Indeed con.firm Dr Holland's roadside observation study. The peculiar association between make of motorcycle and intolerance to helmetwearing appears to cross national boundaries. Perhaps these data, together with Dr Holland's, provide sufficient justification for an international controlled trial in which motorcyclists would be randomly assigned to ride either Harley Davidsons or Hondas. Such a study would greatly clarify the aetiology of helmet intolerance. This problem si:1Quld be a high priority for American injury researchers, becauSe we lack the convenient option available to Australians (and suggested by Dr Holland) of banning the importation of Harley Davidsons. Patrick S Romano, MD, MPH Elizabeth McLoughlin, ScD Institute for Health Policy Studies University of California. San Franc.isco 1388 Sutter Street. 11th Floor San Francisco. CA 94109 1. Holland RB. Helmets for motorcydists petter]. Mea J Aus! 1991; 155: 576. 2. McGrath PJ. Helmets for motorcyclists [letter). Mea J Aus! 1991; 155: 424. 3. Romano PS. McLoughlin E. Helmet use and fatal motorcycle injuries in California. 1987-1988. J Head Trauma Rehabi/1991; 6(2): 21-37.