Peyrot M, Moody P M, Wiese H J
Loyola College Center for Social and Community Research Johns Hopkins University School of Medicine, Baltimore, Maryland.
Int J Psychiatry Med. 1993;23(1):63-80. doi: 10.2190/PFKJ-7NNU-WVLH-33W7.
Based upon three models of etiology and adjustment in CLBP, predictions were made about the variables that were expected to differentiate organic and nonorganic patients, including: psychological distress (anxiety, depression, stress, alienation), pain condition and treatment, and general health.
Patients from a medical school orthopedic clinic with an organic (N = 58) or a nonorganic (N = 33) diagnosis for chronic low back pain (CLBP) were compared on medical, psychological and sociodemographic variables.
Nonorganic patients exhibited greater emotional distress, contrary to the biogenic model, and nonorganic patients did not exhibit more somatic complaints, contrary to the psychogenic model. Both patterns were consistent with the sociogenic model; nonorganic patients were more distressed, but not because of a greater tendency to somatize. Moreover, modeling was not supported as an explanation of the pain and distress among these patients.
Social anomie may explain why patients without a medically diagnosable cause for their pain are more psychologically distressed.
基于慢性下腰痛（CLBP）病因和调适的三种模型，对有望区分器质性和非器质性患者的变量进行预测，这些变量包括：心理困扰（焦虑、抑郁、压力、疏离感）、疼痛状况与治疗以及总体健康状况。
比较了医学院骨科门诊诊断为慢性下腰痛（CLBP）的器质性患者（N = 58）和非器质性患者（N = 33）在医学、心理和社会人口学变量方面的情况。
与生物源性模型相反，非器质性患者表现出更大的情绪困扰；与心因性模型相反，非器质性患者并未表现出更多的躯体主诉。这两种模式均与社会源性模型一致；非器质性患者更为困扰，但并非因为其有更强的躯体化倾向。此外，未证实塑造作用可解释这些患者的疼痛和困扰。
社会失范或许可以解释为何无医学可诊断疼痛病因的患者在心理上更为困扰。
