The psychobiology and management of chronic pain

Abstract

Introduction: The objective of this review is to advance our understanding on the biolecial and psychological perspectives of Chronic Pain. Methods: For research, a PubMed search was conducted on 01.05.2021 using the systematic review filter to identify articles that were published using MeSH terms Chronic Pain, Pain, Psychology of Pain. Systematic reviews or meta-analyses were selected from a systematic search for literature containing diagnostic, prognostic and management strategies in MEDLINE/PubMed. Results: Depression is more common in chronic pain patients (CPPs) than in healthy controls as a consequence of the presence of CP. At pain onset, predisposition to depression (the scar hypothesis) may increase the likelihood for the development of depression in some CPPs. Because of difficulties in measuring depression in the presence of CP, the reviewed studies should be interpreted with caution. Little attention, however, has been given to the development of a comprehensive model that integrates both biomedical and psychological variables in the etiology, maintenance, and exacerbation of chronic pain. The purpose of this article is to propose a dynamic psychobiological model of chronic pain that emphasizes the interaction among psychological and biomedical variables. The experience of pain is viewed as a complex response that incorporates subjective-psychological, motor-behavioral, and physiological-organic components. Moreover, we postulate that there are varying degrees of synchrony among responses measured on these levels determining the development and etiology of chronic pain syndromes.