Psychosomatic Medicine, Vol 59, Issue 6 597-604, Copyright © 1997 by American Psychosomatic Society

ORIGINAL ARTICLES

Iatrogenic factors and chronic pain

K Kouyanou, CE Pither and S Wessely
Department of Psychological Medicine, St. Thomas' Hospital, London, United Kingdom.

OBJECTIVE: Although it is accepted that the etiology of chronic pain is multifactorial, little attention has been given to the possible role of iatrogenesis. The aim of the present study is to identify possible iatrogenic factors in chronic pain patients. METHODS: We report a cross-sectional study of 125 patients attending specialist pain clinics in South London. Data were collected using semistructured checklists. Patients were interviewed with a structured psychiatric interview and were given a questionnaire booklet to complete. RESULTS: We found that possible iatrogenic factors, such as over-investigation, inappropriate information and advice given to patients as well as misdiagnosis, over-treatment, and inappropriate prescription of medication were common in this sample. CONCLUSIONS: We suggest that future studies should take account of the role of the doctors, as well as that of the patients, in the etiology, and hence prevention of chronic pain.

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