Are pain disorder and somatization disorder valid diagnostic entities?

Physicians and other clinicians who treat patients with chronic pain have doubtless recognized the interplay of various psychological and somatic variables in their patients' pain. Notwithstanding, there continues to be primary emphasis on the somatic factors, and continued neglect of the psychological. This article asserts that pain disorder and somatization disorder are indeed valid diagnostic entities, and that their respective incidence and prevalence are quite high both in patients with chronic pain and in the primary care setting. These diagnoses are compared and contrasted, along with the related diagnosis of the psychological factors affecting physical condition. Guidelines for assessment of these conditions are provided, as are recommendations as to when to refer patients for further psychological and psychiatric assessment and treatment.