Assessment of patientsʹ reporting of pain: an integrated perspective

A common assumption about pain is that it always results from the presence of underlying organic pathology. In the absence of objective pathology, an individualʹs report of pain may be ascribed to psychological causes. There is a wide variation in patientʹs experience of pain and organic factors alone cannot explain individual differences in patientsʹ reports. Assessment of patients who report pain requires attention to psychosocial, behavioural, and organic factors. We describe a comprehensive approach to the assessment of psychological and behavioural variables that affect patientsʹ reports of pain. We counter the duality of the somatogenic versus psychogenic perspective and suggest a more integrated assessment that encompasses not only the severity of pain and related physical pathology but also the person who is reporting the presence of pain.