A simple examination of the relationships between pain, organic lesions and psychiatric illness

It is often assumed that pain can be caused by psychological illness and also that severely painful organic lesions may cause emotional change. If these assumptions are correct, pain in the absence of lesions should be associated with a very high rate of psychiatric diagnosis; pain with lesions should occur with psychological illness more often than by chance but less often than in the group without lesions. To test these hypotheses two groups have been compared, one with pain and no evidence of organic lesions, the other with pain proportionate to organic lesions. Ninety-seven per cent of the first group and 39% of the second group were found to have psychiatric conditions (P less than 0.001).