1531 – Pain and psychopathology: the experience of a multidisciplinary chronic pain unit

Abstract

Our modern understanding of pain has moved forward from a simplistic one, viewing pain as a one-dimensional, anatomical, physiological body process, towards the recognition of pain as a complex biological, psychological, social and existential phenomenon. Chronic Pain Unit of Centro Hospitalar de Sao Joao (in the North of Portugal) is a treatment center where both physiological and psychological aspects of pain can be addressed. It provides a multidisciplinary approach to patients with chronic pain, integrating health professionals of several intervention areas, always working in close collaboration. There, we can find Psychiatry/Psychology ambulatory clinic, with two major goals: uncovering any subjacent major psychiatric disorders and identifying emotional influences that underlie or exacerbate primary pain, offering an effective approach to enhance outcome. The authors start by characterizing sociodemographic and psychopathological data, concerning patients followed in this ambulatory clinic (4 year experience). Preliminary results show a preponderance of female adult patients, married, retired or in sick leave. Physical diagnoses are more often degenerative pathology of spine and/or fibromyalgia. Most frequent psychiatric diagnoses are adjustment disorder and dysthymia, as well as histrionic personality disorder. It seems that, in general, pain decreases when psycho-emotional equilibrium improves. Clearly, these comorbidities together require complex evaluation and treatment, in order to improve somatic and emotional pain, and enrich patients’ quality of life. Thereby, patients with chronic pain require careful, comprehensive and integrated multidisciplinary treatment, in which Psychiatry/Psychology definitely plays an important role for a successful outcome.