Cited by 195Psychosomatic Disorders and Their TreatmentsMedicine, History, and PhilosophyFibromyalgia and Chronic Fatigue Syndrome Research

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Chronic Pain, Psychopathology, and DSM-5 Somatic Symptom Disorder

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Katz, Joel, Rosenbloom, Brittany N, Fashler, Samantha·2015·The Canadian Journal of Psychiatry

DOI 10.1177/070674371506000402PMC PMC4459242

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Abstract

Unlike acute pain that warns us of injury or disease, chronic or persistent pain serves no adaptive purpose. Though there is no agreed on definition of chronic pain, it is commonly referred to as pain that is without biological value, lasting longer than the typical healing time, not responsive to treatments based on specific remedies, and of a duration greater than 6 months. Chronic pain that is severe and intractable has detrimental consequences, including psychological distress, job loss, social isolation, and, not surprisingly, it is highly comorbid with depression and anxiety. Historically, pain without an apparent anatomical or neurophysiological origin was labelled as psychopathological. This approach is damaging to the patient and provider alike. It pollutes the therapeutic relationship by introducing an element of mutual distrust as well as implicit, if not explicit, blame. It is demoralizing to the patient who feels at fault, disbelieved, and alone. Moreover, many medically unexplained pains are now understood to involve an interplay between peripheral and central neurophysiological mechanisms that have gone awry. The new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, somatic symptom disorder overpsychologizes people with chronic pain; it has low sensitivity and specificity, and it contributes to misdiagnosis, as well as unnecessary stigma. Adjustment disorder remains the most appropriate, accurate, and acceptable diagnosis for people who are overly concerned about their pain.

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Authors: Katz, J., Rosenbloom, B. N., & Fashler, S.
Affiliations: York University (CA)
Corresponding author: Katz, Joel
ORCID: Katz, Joel
Rosenbloom, Brittany N
Fashler, Samantha
Venue: The Canadian Journal of Psychiatry
Publisher: SAGE Publications
Published: 2015-04
Volume: 60
Issue: 4
Pages: 160-167
ISSN: 0706-7437 (ISSN-L)
1497-0015
DOI: 10.1177/070674371506000402
PMC: PMC4459242
OpenAlex: W1878522659
Cited by: 195
References: 71
Citations by year: 2026: 17 · 2025: 17 · 2024: 20 · 2023: 21 · 2022: 20 · 2021: 21 · 2020: 15 · 2019: 17 · 2018: 18 · 2017: 17 · 2016: 9 · 2015: 2
FWCI: 2.11
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: The Canadian Journal of Psychiatry (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
YorkSpace (York University) (submittedVersion)
Canadian Psychiatric Association Journal
Funders: Canadian Institutes of Health Research
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
Social Sciences › Arts and Humanities › History and Philosophy of Science › Medicine, History, and Philosophy
Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
Keywords: chronic pain, somatic symptom disorder, DSM-5, psychosomatic pain, medically unexplained pain, depression, anxiety, adjustment disorder, misdiagnosis, stigma, central sensitization, diagnostic validity, therapeutic relationship
MeSH terms: Humans, Somatoform Disorders, Diagnostic and Statistical Manual of Mental Disorders, Chronic Pain

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Chronic Pain, Psychopathology, and DSM-5 Somatic Symptom Disorder

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