HOW NOT TO MISS A SOMATIC NEEDLE IN THE HAYSTACK OF CHRONIC PAIN

Interviews with 18 male patients with predominantly psychogenic pain ( DSM-III and DSM-III-R) and with 18 male patients with pain of mainly p hysical origin, consecutively admitted to a medical department, were r ated by blinded and independent raters with respect to ''symptom descr iption,'' ''manner of speech,'' ''personality characteristics,'' ''int erviewer reactions,'' ''interpersonal relationships,'' and ''relations hips at work.'' Patients with predominantly organic pain significantly more often described a clear localization of the pain symptom, used m ore sensory words for the description of pain quality; more often desc ribed discrete changes of pain intensity and periodicity; more often s howed pain intensifying factors dependent on movement and pain-decreas ing factors; more often believed pain to be a symptom versus as a dise ase itself, and tended to have fewer difficulties in their interperson al relationships than those with predominantly psychogenic pain (p<0.0 5 for all factors, two-tailed Fisher's Exact test). (C) 1997 Elsevier Science Inc.