Article Index

Special problems with physiologically-induced pain disorders

A very serious red flag is raised in the actual criteria: " XXX.3 Pain disorder. This classification is reserved for individuals presenting predominantly with pain complaints who also have many of the features described under criterion B." Criterion B requires that two of five conditions be met. B's conditions would be fulfilled if the patient experienced a "high level of health-related anxiety" and that "health concerns assume a central role in their lives". Medicine currently has come to realize that pain itself can no longer be relegated to the periphery of clinical concern and should no longer be waved off as a "mere symptom"—but should be fully investigated.

Pain is a legitimate medical symptom and is now recognized at the "fifth vital sign" to be evaluated by physicians, along with blood pressure, pulse, respiratory rate and temperature. Untreated pain can become very detrimental to a person's health as well as very disabling. Pain, in the joints, sore throat (chronic mononucleosis, a known medical diagnosis), and other conditions are all too often psychiatrically dismissed. The misleading nature of the diagnosis of pain in the draft CSSD definition can have serious consequences.

Clearly the CSSD disorder is not only theoretically flawed and disparate, but as a practical methodology, it is a potential minefield for medical and psychiatric practices and the patients seeking their assistance.