Most patients with chronic pain have some degree of psychological disturbance.
Patients may be anxious or depressed, or have trouble coping. Psychological
distress may not only be a consequence of the pain, but may also contribute
to the pain itself. “Psychogenic” pain is a simple label for
all kinds of pain that can be best explained by psychological problems.
This close relationship between pain and psychological distress means
that all patients with chronic pain should have an assessment of these
psychological factors, and psychological treatments should be considered
an important aspect of pain therapy. In some cases, psychological problems
appear to be a main cause of the pain. This does not mean that the person
is not actually experiencing the pain. Rather, the patient is truly suffering
but the main cause somehow relates to the emotions, or to learning, or
to some other psychological process. Although doctors sometimes encounter
patients who pretend to be in pain (some can be called malingerers), this
appears to be a rare occurrence. Most patients with pain that appears
to be determined primarily by psychological processes are hurting just
like those who have pain associated with a clear injury to the body.
Sometimes, psychogenic pain occurs in the absence of any identifiable
disease in the body. More often, there is a physical problem but the psychological
cause for the pain is believed to be the major cause for the pain. The
various types of psychogenic pain can be diagnosed using a classification
developed by psychiatrists (the Diagnostic and Statistical Manual of the
American Psychiatric Association).
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