Review article

Pain Psychiatry: Chronic Pain and Mental Health

Žana Kralj

Abstract

Chronic pain is a complex condition characterized by the interaction of neurobiological, psychological, and social factors, extending beyond the traditional view of pain as a purely somatic symptom. The integration of psychiatric perspectives into pain assessment and management highlights the importance of addressing the emotional and cognitive dimensions of the pain experience. Chronic pain is frequently associated with depression, anxiety, and sleep disorders, with a well-established bidirectional relationship between pain and psychiatric symptoms.
The pathophysiology of chronic pain involves mechanisms such as central sensitization, alterations in neurotransmitter systems (serotonin, norepinephrine, and dopamine), neuroinflammation, and dysregulation of the hypothalamic–pituitary–adrenal axis, as well as changes in brain networks involved in emotional processing.
Management is based on the biopsychosocial model and includes pharmacological treatment, psychotherapeutic interventions, and rehabilitation strategies. Antidepressants play an important role in modulating pain through descending inhibitory pathways, while psychotherapeutic approaches, particularly cognitive behavioral therapy and mindfulness-based interventions, have been shown to reduce pain intensity and improve functional outcomes. A multidisciplinary approach is essential for providing effective and comprehensive care for patients with chronic pain.

Keywords

chronic pain, depressive disorder, anxiety disorders, biopsychosocial model, pain management, psychotherapy

Hrčak ID:

349486

URI

https://hrcak.srce.hr/349486

Publication date:

10.7.2026.

Article data in other languages: croatian

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