Chronic pain disorder following physical injury

Pain disorders that are primarily associated with psychological factors are of great clinical concern, but they are difficult to study because of the inability to make valid or reliable diagnoses by structured interview alone . The authors confront this difficulty by using an injured subject populati on that had extensive psychiatric and medical evaluations. Those who develo ped somatoform pain disorder (SPD) were compared with a control group who d id not. The SPD group had distinctive associated factors: more sites of pai n, spread of pain beyond area of original injury and substantially more opi ate and benzodiazepine use. Compensation/litigation influenced symptoms mor e in the SPD group. Psychotherapists often supported the patient's viewpoin t that the pain was physical and to be endured.