Psychiatric aspects of pain.
OBJECTIVE
Pain is a common reason for seeking healthcare. Chronic pain is commonly comorbid with psychiatric disorders. New evidence provides fresh insights into the nature of the link between pain and mental disorders and offers opportunity to refine treatment approaches.


RESULTS
Even though depression is the most commonly studied comorbid psychiatric disorder, new studies show that other mental disorder, especially anxiety disorders, are also common. Comorbid conditions, including other chronic physical conditions, account for a substantial proportion of the disability associated with chronic pain conditions. The causal link between chronic pain and mental disorders may vary depending on the specific mental disorder, but the link may be mediated by biological, psychological, and social factors. Recent findings also suggest that the evolution of the comorbidity may differ between the sexes. Promising interventions for chronic pain that also target contextual psychosocial problems have been recently described.


CONCLUSIONS
The frequent occurrence of mental disorders among patients with pain, especially those whose pain is chronic, has implications for the management of such patients. Current understanding of the complexity of this link not only provides opportunities for designing appropriate interventions but also raises new questions for further research.
Gureje
Oye
O
Department of Psychiatry, University of Ibadan, University College Hospital, Ibadan, Nigeria. ogureje@comui.edu.ng
D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D002908:Chronic Disease; D003131:Combined Modality Therapy; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D059408:Pain Management