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The Assessment of Chronic Pain

The role of psychological assessment of chronic pain has been met with some confusion. Clinicians use psychological assessment to diagnose psychological conditions that can contribute to pain to clarify medically unexplained sources of pain. Over 30 years of research provide strong evidence to support the claim that there is a close relationship between chronic pain and psychosocial issues, and psychological assessment is, therefore, often necessary for proper diagnosis and treatment of chronic pain.

There are many types of psychosocial assessment that may be related to chronic pain. These  are used to help and understand the cause and severity of pain. It is important to keep in mind that comorbid psychiatric disorders are not the same as psychological factors that influence chronic pain. Though there is certainly a relationship between psychiatric disorders and chronic pain, these disorders are generally not the cause of a chronic pain disorder. However, how a person perceives the world around them does affect how they perceive pain. Therefore, psychosocial factors may be used to help understand how individuals respond to pain and which individuals are more likely to develop chronic pain, and what psychological, social, and family factors might be integrated into the diagnostic and treatment process.  As you can see, the assessment of chronic pain is complicated and requires a sensitivity to a variety of factors.

For individuals suffering from chronic pain, comorbid depression occurs in up to 52% of individuals in pain clinics, 27% in primary care facilities, and 18% in population-wide studies on chronic pain. For the general population, depression is present in 5-10% of individuals. So, you can see that depression occurs up to 10 times more frequently in patients suffering from chronic pain compared to those without chronic pain.  Similarly, anxiety accompanied by depression is more common in those who suffer from chronic pain (23%), as opposed to 12% in those who do not experience chronic pain.  These findings do not indicate that one disorder causes the other or that they can be lumped into one disorder; each disorder should be assessed and treated separately. This means that there should be a thorough assessment of chronic pain as well as the possible psychological and psychosocial factors that may be related to chronic pain.

We know that chronic pain is very difficult to live with, creates numerous losses, produces fears related to activity, interferes with relationships, etc.  Who wouldn’t be depressed? Chronic pain studies have shown that the assessment of chronic pain shows that the most common psychological problems are related to depression, anger, and anxiety. For most individuals, the increased prevalence of these moods has also been linked to reduced tolerance for pain, reduced thresholds for pain, and a higher level of reported pain.

In order to properly assess and treat chronic pain, social, psychological, and biological components must be factored into the diagnostic and treatment processes. The following six components should be taken into account in an assessment of chronic pain: physical function, emotional function, the intensity of pain, the patient’s disposition, the patient’s improvement rating, and any comorbid symptoms and/or negative side effects. These factors help to predict the underlying components of chronic pain, as well as the potential success of various treatment models.

Because our treatment for depression and anxiety programs rely on evidence based practices, our Intensive Outpatient Program shares many common methods with other successful treatment methods.  The foundation of our treatment program for relies on the principles of the stages of change, cognitive behavioral therapy, solution focused treatment, skills training and identifying repetitive dysfunctional behavioral relationship patterns to promote recovery from depression and other mental health disorders.  In fact, our Intensive Outpatient Program in Memphis, TN that has been proven to be effective in the treatment of these disorders in six peer reviewed treatment outcome studies.

Unfortunately, less half of all individuals with any mental illness in Tennessee will receive mental health treatment.  Our treatment center provides services to those who need more treatment than one hour a week, but less than 24 hour care, by providing three hours of treatment per day, three to five days per week, in an intensive outpatient setting. It is also important to keep in mind that women and men often experience depression differently and therefore the presence of depression may also appear differently based on gender. If you or a loved one is showing signs of depression or anxiety, including PTSD, they should be assessed by a trained mental health professional who can help design a treatment plan for depression that can result in recovery.  Treatment for depression and anxiety can be highly successful.  People who have completed our program have provide very high consumer satisfaction scores and reviewsCall us at 901-682-6136 to schedule an appointment.