[The Explanatory Model-Interview in the diagnosis of orthopaedic pain patients].
OBJECTIVE
This study aims to clarify weather the Explanatory Model Interview (EMIC, Weiss, 1997) can detect differences between pain patients with somatoform disorders and pain patients without any psychiatric disorder. We consider the importance of psychological symptom reporting, somatic illness attribution and the subjective experience of exhaustion.


METHODS
The (EMIC) and the Structured Clinical Interview for DSM-IV (SKID) were administered to 87 in-patients recruited from the pain therapy ward of the Orthopaedic Clinic in Heidelberg, Germany. The analysis of the EMIC strongly reflects interactional factors and the subjective importance for the patients.


RESULTS
Patients with somatoform disorders reported more psychological distress than patients without psychiatric disorder, especially after inquiry. Physical exhaustion was clearly more important in the symptom attribution of somatic pain patients, but an exclusive somatic illness attribution did not appear more often in this group of patients.


CONCLUSIONS
Most pain patients with somatoform disorders report psychological distress when they are encouraged. In spite of this emotional strain, most of the pain patients with somatoform disorders attribute their pain complaints to somatic causes. The conspicuous importance of exhaustion in the attribution of patients with somatoform disorders confirms clinical observations and requires further research.
Schröter
C
C
Orthopädische Universitätsklinik Heidelberg. corinna_schroeter@t-online.de
Schiltenwolf
M
M
Fydrich
T
T
Henningsen
P
P
D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008875:Middle Aged; D010146:Pain / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013001:Somatoform Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology*; D011795:Surveys and Questionnaires