Review article

Psychological and psychiatric factors of chronic pain

Danijel Buljan ; Department of psychiatry, University hospital Sestre milosrdnice, Zagreb, Croatia

Abstract

Chronic pain syndrome is a major health and socioeconomic problem that is manifested by frequent asking of medical assistance, high price of health care, sick leave, work inability and disability as well as frequent compensation requests. Generally speaking, pain, especially chronic pain, significantly diminishes the patient and their family’s quality of life. Most people experience one or more pain disorders during their life. Chronic pain prevalence accounts for 15 to 22% in population. It occurs more frequently in women, in older age and persons of decreased socioeconomic status. Chronic pain can be causally linked to comorbid psychiatric disorders, such as fear of physical illness, constant worry, anxious disorders, depression and reaction to stress. Every pain, especially chronic, has psychological characteristics as well which are expressed to an extent. When the pathophysiologic factor is known, the pain is conventionally classified as “specific” and when it is unknown it is called “nonspecific”, psychogenic, idiopathic, conversive or euphemistic atypical pain. Nonspecific pain is very often a symptom of a psychiatric disorder or it is classified in the group of somatoform psychiatric disorders according to contemporary classification systems, e.g. the American Psychiatric Association’s DSM-IV and the International Classification of Diseases (ICD-10). Psychosomatic medicine studies the connection of psychological conditions and psychiatric disorders, psychosocial stress, family and occupational factors with somatic disorders. On the other hand, a painful somatic illness can cause anxiety, depression, social phobia and isolation. Treating nonspecific psychogenic pain disorder is not possible without a holistic, integrative, interdisciplinary team approach of psychiatrists, psychologists, physiologists, neurologists and sometimes even neurosurgeons. Cognitive-behavioral psychotherapy is prevalent as well as techniques of alleviating anxiety and stress (autogenic training), physiologic therapy, EMG biofeedback methods and psychopharmacotherapy.

Keywords

pain disorder; “nonspecific pain”; “specific pain”; psychalgia; idiopathic; psychotherapy; psychopharmacotherapy

Hrčak ID:

42389

URI

https://hrcak.srce.hr/42389

Publication date:

20.10.2009.

Article data in other languages: croatian

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