Somatization and chronic pain

Abstract

The experience of pain is related not only to tissue damage and physical illness, but also to mental phenomena including depression, anxiety and somatization. Somatization is common among chronic pain patients and presents special problems in management and treatment. Somatoform patients are often given inappropriate diagnoses, treated for non-existent depressive disorders, and exposed to multiple, superfluous investigations. Psychological models of chronic pain and somatization are presented, and treatment issues including psychotherapy and the use of antidepressants are discussed.

Psychological factors in chronic pain: A worthwhile undertaking for nursing?

“…Although the prevalence of this disorder is largely unknown, antidepressant medication and cognitive-behavioral psychotherapy seem to be the most effective treatment modalities (Birket-Smith, 2001). Psychiatric nurses must be aware that even though a patient is diagnosed with SPD, it doesn't necessarily mean that there is no organic cause for their pain, technology may not yet be sophisticated enough to detect an organic cause.…”

“…Somatization is defined as repeated presentation of physical symptoms, together with persistent requests for medical investigations, despite repeated negative findings and reassurances by doctors that the symptoms have no physical basis (World Health Organization, 1992). In 1987, the American Psychiatric Association established a psychiatric diagnosis, Somatoform Pain Disorder (SPD), describing those persons who report persistent pain in the absence of specific physical or psychiatric pathology; however, epidemiologic studies of somatoform pain show a large variance in the prevalence rates, ranging from 0% to 53% (Birket-Smith, 2001). Little research has been done in the area of SPD, contributing to uncertainty in diagnosing and/or differentiating somatoform pain from other somatoform disorders.…”

“…Physical symptoms for psychological reasons have been speculated for years with chronic pain and somatization often being linked (Birket-Smith, 2001). Somatization is defined as repeated presentation of physical symptoms, together with persistent requests for medical investigations, despite repeated negative findings and reassurances by doctors that the symptoms have no physical basis (World Health Organization, 1992).…”

Association between somatization subscale score and serotonin transporter availability in healthy volunteers—a single photon emission computed tomography study with [123I] ADAM

“…Although the effect of antidepressants in somatoform disorders is only supported by a limited number of studies, it is believed that the actions of antidepressants may modulate, either directly or indirectly, 5-HT metabolism or function (Birket-Smith 2001;Zhu and McNaughton 1994).…”

Eingeschr�nkte Wirksamkeit von Opioiden bei chronischen muskuloskelettalen Schmerzen

“…Tabelle 3 aufgeführt werden.4 von 2 Patienten waren aufgrund ihrer Beschwerden bereits operiert worden; bei 7 Patienten war eine Nukleotomie erfolgt, bei 7 war eine Spondylodese an der LWS, bei einem Patienten eine Dekompression an der HWS und bei 2 Patienten eine Arthrodese des oberen Sprunggelenks durchgeführt worden.Bei der Aufnahme wurde die Schmerzintensität von den Patienten auf der numerischen Schmerzskala im Mittel mit 8 (7,98±,66) angegeben. Nach dem Opioidentzug bei Entlassung lag die angegebene mittlere Schmerzintensität bei 6ADS-K -Allgemeine Depressions-SkalaAbb 4. 8 Signifikante Verbesserung der Funktionskapazität, FFbH-R -Funktionsfragebogen Hannover Rücken FFbH-R) erreichte bei der Aufnahme einen Gesamtmittelwert von 36% (35,55±2,09), bis zur Entlassung wurde die Funktionskapazität auf 42% (4,75±23,54) signifikant (p=0,002) gesteigert (.…”