Pain in Women pp 237-253 | Cite as

Immune Consequences of Early Life Stress: Relationship to Chronic Pain Syndromes

  • Linda L. CarpenterEmail author
  • Cyrena E. Gawuga


Although a strong connection between chronic pain and mental health disorders has long been recognized by clinicians, by researchers, and even by many patients themselves, the specific nature of this relationship has been poorly understood. Clinicians’ assumptions about the direction of causality between psychiatric syndromes and physical symptoms can greatly impact quality of patient evaluation and perhaps lead to suboptimal treatment of the patient presenting with pain. Patients’ concerns about the clinician’s assumptions with regard to these issues may lead to underreporting of important and relevant history or symptoms, which in turn may also promote suboptimal care. The common copresentation of chronic pain syndromes and mental health conditions may leave the clinician struggling with a which came first? mindset. Do mental illnesses cause the onset of physical pains or impair one’s ability to cope with physical symptoms? Or, alternatively, does unrelenting physical discomfort lead to the onset of psychological symptoms and the development of psychiatric disorders such as major depression? A clinician’s approach to the patient and choice of interventions may be dramatically altered when working with the understanding that a shared biological etiopathology can produce either a chronic pain syndrome or a psychiatric disorder or, perhaps more commonly, a presentation with features of both these conditions.


Irritable Bowel Syndrome Chronic Fatigue Syndrome Adaptive Immune System Enteric Nervous System Interstitial Cystitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Brown Department of Psychiatry and Human BehaviorBrown University School of Medicine, Butler HospitalProvidenceUSA

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