title: Psychiatric and psychological perspectives on chronic pain.
abstract: Chronic pain patients often have psychiatric disorders that negatively influence their responses to treatment. Also, many of them have dysfunctional beliefs and coping strategies, even if they do not meet DSM-5 criteria for a psychiatric disorder. Physiatrists should have a low threshold for referring both groups of patients for mental health services. This article describes psychiatric disorders that are highly prevalent among pain patients and also describes psychological processes that contribute to poor coping by the patients. Finally, it discusses factors that a physiatrist should consider in deciding whether to refer patients to psychiatrists versus psychologists.
authors.affiliation: Physical Medicine & Rehabilitation, University of Washington, Seattle, WA, USA.
authors.forename: Catherine Q
authors.initials: CQ
authors.lastname: Howe
authors.affiliation: Physical Medicine & Rehabilitation, University of Washington, Seattle, WA, USA. Electronic address: jimrob@uw.edu.
authors.forename: James P
authors.initials: JP
authors.lastname: Robinson
authors.affiliation: Physical Medicine & Rehabilitation, University of Washington, Seattle, WA, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Sullivan
mesh_terms: D000223:Adaptation, Psychological; D059350:Chronic Pain / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D001523:Mental Disorders / Q000523:psychology*; D059408:Pain Management; D010147:Pain Measurement; D012017:Referral and Consultation
keywords: Coping strategies; Dysthymia; Fear avoidance; Illness beliefs; Major depressive disorder; Panic disorder; Posttraumatic stress disorder; Substance use disorders