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Misdiagnosis of chronic pain as hysteria and malingering
Authors:Allan P Shapiro PhD  Robert W Teasell MD
Institution:(1) Psychological Services, Department of Physical Medicine and Rehabilitation, University of Western Ontario and London Health Sciences Centre, University Campus, 339 Windermere Road, N6A 5A5 London, ON, Canada;(2) Associate Professor of Medicine, Chief, Department of Physical Medicine and Rehabilitation, University of Western Ontario and London Health Sciences Centre, University Campus, 339 Windermere Road, N6A 5A5 London, ON, Canada
Abstract:Chronic soft tissue pain disorders are not well understood from a pathophysiologic standpoint. Psychologic difficulties are common, clinical signs incompatible with conventional understanding of the nervous system are often present, and these disorders usually fail to respond to medical intervention.When this constellation of factors is combined with unresolved litigation-compensation issues, it is not surprising that chronic pain disorders are often misdiagnosed as hysteria or malingering. Unfortunately, these diagnoses may have significant negative consequences that are not often appreciated and may compromise treatment.
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