Clinical diagnosis of psychogenic rheumatism

Rheumatic symptoms that are a somatic expression of emotional disturbance are common, and often are mistakenly attributed by physicians to organic disease. Psychogenic rheumatism is encountered most frequently among middle-aged women. The typical complaint is of widespread pain and stiffness, often with report of swelling and paresthesia, but symptoms characteristically are vague. Overt psychiatric disturbance may be apparent. Distinction from organic disease should not be difficult if physicians recognize the typical presentation, and find that symptoms fail to correspond to patterns of organic disorders. When organic disease coexists with psychogenic rheumatism, as often is the case, the objective abnormalities are insufficient to explain the symptoms.