Only pain disorder with both psychological factors and a general medical condition will be diagnosis because pain is a subjective experience and have no test thus we can never know whether it is a psychological or physical. Inter-rater reliability is poor, culture plays a moderating roles. Pain disorders are often co-morbid with substance abuse e. g. pain killers, anxiety, These patients are reinforced and develop into iatrogenic disability; reinforcement of and depression being disabled. Typically women suffer from body dysmorphic disorders than men, and will be more specific. It is important to know that patients, who suffer from body dysmorphic disorders (bdd), often have obsessive compulsive personality disorder characteristics. They are obsessed with looking at their defective reflection in mirror. Depression, social phobia co-morbit because imagine defect and not want to be in public, or sad about defects. They usually meet the criteria of a delusional. 5% of the population might have hypochondriacs, and is chronic.