• M Peyrot, P M Moody, and H J Wiese.
• Loyola College Center for Social and Community Research Johns Hopkins University School of Medicine, Baltimore, Maryland.
• Int J Psychiatry Med. 1993 Jan 1;23(1):63-80.

ObjectiveBased 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.MethodPatients 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.ResultsNonorganic 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.ConclusionsSocial anomie may explain why patients without a medically diagnosable cause for their pain are more psychologically distressed.

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