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KMID : 0371719970130010015
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Wonkwang Psychiatry
1997 Volume.13 No. 1 p.15 ~ p.28
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Neuropsychiatric Aspects of Chronic Pain Syndrome
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Abstract
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Chronic pain is usually defined as pan which lasts more than 6 months and does not indicate ongoing tissue destruction. Efforts to identify and correct causative pathology are often not beneficial. Chronic pain occurrs most commonly in headache,
back
pain, arthritis, cancer, and certain psychiatric disorders, such as major depression, anxiety disorders, somatoform disorders, hypochondriasis, and psychogenic pain disorder.
Chronic pain persists despite the intervention of medical treatment and the passage of time. Patient and physician alike are unable to give a satisfactory explanation for the presence and continuation of the pain. The time course of chronic pain
is
unknown. The physiological, anatomical, and biochemical pathology identified by physical examination and diagnostic tests usually do not adequately uncover the cause of pain.
Patients with chronic pain display little automatic hyperactivity. They exhibit neuro-vegetative symptoms such as disturbed sleep, altered appetite and weight, decreased libido and energy, diminished concentration, and irritability. Such patients
usually have a history of multiple medical and surgical interventions aimed at relieving the cause of the pain. The associated emotional distress, family disturbance, economic hardship, and altered life style secondary to the persistent pain
become
significant problems in themselves. Generally, he longer a patient suffers from chronic pain, the more psychological and social factors influence the course of the syndrome. In addition to exhibiting increased irritability, chronic pain patients
show
signs social withdrawal. They become increasingly inactive as their pain persits. In addition to the emotional distress, inactivity, and social isolation experienced by these patients, they often believe that their persistent pain arises from a
serious
disease. It may be useful to view the disability of patients with chronic pain as a form of abnormal pain behavior.
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