Identifying the origins of chronic pain, and determining whether the pain is primarily physical or psychogenic, is a very difficult task. This study examined two groups of patients—one group designated as having organic pain, and another as having psychogenic pain—and compared how members of each group responded to interview questions.
The following differences between the two groups were identified:

  • The organic pain group (OP) localized their pain more, while for the psychogenic pain (PP) patients, the pain was more diffuse and vague.
  • The OP group used more sensory rather than affective and evaluative words when describing their pain. " example of an 'affective' adjective: frightening; and a 'sensory' adjective: burning."
  • "The OP group described more discrete changes in pain intensity and in periodicity. The OP group more frequently mentioned pain intensifying factors, and intensifying factors dependent on voluntary movement." The OP patients were also more likely to mention factors that decreased their pain than the PP patients.
  • Men in the OP group were more likely to see their pain as a symptom, rather than a disease itself.
  • The OP men more often had intact personal relationships, and "used straightforward, simple language, free of medical jargon" to describe their pain.

The authors conclude that these factors may be a useful tool (but, of course, not the only tool) in determining the origin of pain symptoms when evaluating patients with chronic pain.

Adler RH, Zamboni P, Hofer T, et al. How not to miss a somatic needle in the haystack of chronic pain. Journal of Psychosomatic Research 1997;42(5):499-506.