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EPA-0320 – The Language of Pain: How to Understand, Diagnose and Manage Chronic Pain in the Consultation-liaison Psychiatry Setting

Published online by Cambridge University Press:  15 April 2020

S. Ferrari*
Affiliation:
Diagnostic and Clinical Medicine and Public Health section of Psychiatry, University of Modena & Reggio Emilia, Modena, Italy

Abstract

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Background:

Pain is one of the most common complaints reported by patients, universal, disabling and often unspecific as to diagnosis, etiology and physiopathology. It is a complex experience, truly bio-psycho-social in its essence and therefore demanding multidisciplinary assessment and management.

Method:

The database of the Modena Consultation Liaison Psychiatry (CLP) Service, operating in a 700-bed University General Hospital and providing an average of 1200 first psychiatric assessments annually, was searched quali-quantitatively to provide relevant examples illustrating the process of diagnosis and management of chronic pain: specifically, collaborations with the headache outpatient clinic, rheumatology and onco-ematology were analyzed and compared.

Results:

In the assessment and management of pain in a CLP context, the following aspects are particularly relevant: 1) need to include systematic, standardized assessment of pain (by means of simple instruments like VAS); 2) psycho-pharmaceutical issues, i.e. related to abuse and addiction to pain-killers or anesthetic actions of psychiatric medications; 3) contextualization of pain within patients’ life- and health-history, i.e. the meaning of pain in the migrant patient; 4) the role of pain in the agitated patient with delirium/dementia.

Conclusions:

CLP and psychosomatic medicine play a crucial role in the management of patients with chronic pain, on many different levels, i.e. psychotherapeutic understanding of pain; research on neurobiology; integration and coordination of multidisciplinary care.

Type
S520 - Shades of Pain: Cultural and Liaison-Psychiatric Perspectives on a Major Health Issue - joint symposium of EPA sections “Cultural Psychiatry” and “CL-Psychiatry and Psychosomatics”
Copyright
Copyright © European Psychiatric Association 2014
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