Biopsychosocial pain medicine and mind-brain-body science.
This article reviews how emotions, behavior, and psychiatric comorbidity influence the course and outcome of chronic pain disorders and addresses methods of identifying and managing these problems in clinical practice. Successful medical rehabilitation for patients with chronic pain requires (1) appreciating the effects of biopsychosocial factors in the onset, course, and outcomes of pain disorders; (2) understanding neurobiologic mechanisms linking mind, brain, and body in the functions of pain perception and modulation; and (3) being able to review critically and use selectively the plethora of new medications and interventional technologies that are proposed in the literature. Deficits in these skills now are recognized as hazardous to the public health so that medical school education and post residency training in pain medicine is now mandatory in some states.
Gallagher
Rollin M
RM
Pain Management, Philadelphia VA Medical Center, University and Woodland, Philadelphia, PA 19104, USA. rgallagh@mail.med.upenn.edu
D000698:Analgesia / Q000379:methods*; D000928:Antidepressive Agents / Q000627:therapeutic use; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001521:Behavior Therapy / Q000379:methods; D002908:Chronic Disease; D000529:Complementary Therapies / Q000379:methods*; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D019222:Mind-Body Relations, Metaphysical; D010146:Pain / Q000150:complications / Q000503:physiopathology / Q000523:psychology*; D059408:Pain Management
D000928:Antidepressive Agents