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Psychological Co-morbidities in Patients with Pain

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Abstract

Pain is a biopsychosocial phenomenon which may be variously affected by a host of anatomical, physiological, psychosocial, and environmental factors. Pain is among the most common reasons that patients pursue professional evaluation and treatment, and at present, a rate that is posing substantial strain on the healthcare system. Multiple challenges confront medical providers attempting to accurately diagnose and treat patients presenting with pain including diffuse symptom presentations, common absence of physical findings, and insufficient physician training. Psychological factors such as depression, anxiety, somatization, personality, and maladaptive coping are disproportionately represented in individuals reporting pain, and these psychosocial factors have been empirically shown to exert a strongly negative influence on treatment outcome and functional improvement. This chapter reviews prevalence of mood issues in individuals reporting pain, influence of psychosocial factors on functional treatment outcome, and assessment and treatment challenges faced by multidisciplinary providers. The additional phenomena of fear of pain and associated activity avoidance (e.g., kinesiophobia) and pain catastrophizing have emerged as significantly impacting pain treatment outcomes, and assessment and treatment issues regarding these phenomena are investigated. Efficacy of psychological interventions, particularly cognitive and behavioral interventions to reduce pain and improve patient function, is reviewed. Diagnostic challenges incumbent in the DSM system are discussed, and recommendations for future work are offered.

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Van Dorsten, B., Weisberg, J.N. (2011). Psychological Co-morbidities in Patients with Pain. In: Pagoto, S. (eds) Psychological Co-morbidities of Physical Illness. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0029-6_7

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