OCCUPATION NEUROSES AND THE PSYCHOGENIC CONNOTATION OF
"REPETITION STRAIN INJURY": THE MISCONSTRUCTION OF NEUROSIS

[Integrative Psychiatry, volume 10, Number 4, 1994: 165-176.]

John L. Quintner MB BS MRCP FFPMANZCA
Physician in Rheumatology, Wyllie Arthritis Centre, 17 Lemnos St Shenton Park WA 6008
Milton L. Cohen MB BS MD FRACP FACRM FFPMANZCA
Physician in Rheumatology and Pain Medicine, St. Vincent's Hospital, NSW 2010
Associate-Professor, University of NSW, Sydney.

Abstract

The cervicobrachial pain syndrome known as Repetition Strain Injury (RSI) has been the subject of
considerable controversy, particularly between the proponents of somatogenic and of psychogenic theories of pathogenesis. The latter, who consider that RSI is a neurosis, namely conversion hysteria, argue further that it is a contemporary example of an Occupation Neurosis, as described in the late 19th century. In this paper the history and clinical application of the construct of Occupation Neurosis is reviewed, to examine the proposed analogy with RSI. It is shown that those who argued that RSI was psychogenic failed to appreciate the evolution in terminology and aetiology of the older construct, a misconstruction with major consequences.

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