Psychology, Psychiatry and Chronic Pain (eBook)

Front Cover 1
Psychology, Psychiatry and Chronic Pain 4
Copyright Page 5
Table of Contents 6
List of Contributors 8
Foreword 10
Preface 14
Part I: Descriptive Issues 16
Chapter 1. Basic concepts of pain 18
Incidence 18
Definition of pain 19
Anatomy of pain 20
Types of nerves 20
The gate theory 22
Physiology of pain 24
Relevance of these mechanisms in chronic pain 25
Measurement of pain 26
Bibliography 30
Chapter 2. Classification of pain 32
Schema to aid classification of emotional factors 36
Conclusion 38
Bibliography 38
Chapter 3. Psychological dimensions of chronic pain 40
Pain sensation 42
Pain evaluation 45
Pain affect 48
Pain behaviour 53
Summary 57
Bibliography 58
Chapter 4. Chronic pain problems and psychiatry 60
Monism of experience and dualism of aetiology 62
Psychiatric diagnosis and organic diagnosis 63
The process of selection 65
Psychiatric diagnosis in pain patients 66
The effects of pain 69
References 70
Chapter 5. Psychiatric and psychological issues in different illnesses 72
Headache 72
Orofacial pain 74
Disorders of the neck 77
Chronic abdominal pain 77
References 80
Bibliography 80
Chapter 6. Chronic pain and compensation 82
The compensation system and chronic pain 83
The effect of compensation on response to treatment 85
Comparison studies 87
Discussion 89
References 92
Part II: Assessment and Intervention 94
Chapter 7. Assessment measures 96
Factors in history and examination 97
Assessment instruments 101
Predisposing factors to psychiatric illness in chronic pain 106
Factors affecting response to treatment 108
Conclusion 108
References 109
Chapter 8. Psychotropic drugs 110
History of use of psychotropic drugs for chronic pain 110
Practical use of psychotropic drugs for the treatment of chronic pain 115
Examples of chronic pain conditions that can be treated by psychotropic drugs 117
Summary 119
Acknowledgements 120
References 120
Chapter 9. Behavioural techniques 122
Introduction 122
Behavioural assessment 122
Treatment 123
Summary 132
Bibliography 133
Chapter 10. Use of relaxation 134
Introduction 134
Rationale of relaxation therapy 135
Relaxation training guidelines 137
Relaxation methods 138
Progressive and differential muscle relaxation 139
Instructions for muscle relaxation 140
Choice of relaxation methods 145
Bibliography 145
Appendix 146
Chapter 11. Cognitive therapies 152
Introduction 152
Why beliefs and cognitions matter 153
Explaining and understanding pain 154
Negative thinking 156
Thought stopping 158
Cognitive therapy 159
Cognitive coping strategies 159
Conclusion 162
Bibliography 162
Chapter 12. Hypnosis 164
The nature of the hypnotic state 164
Hypnosis in pain 165
Factors determining response in hypnosis 166
Induction of hypnosis 167
Conclusion 169
Organizations providing training in hypnotism 169
Bibliography 170
Chapter 13. Information about pain 172
Introduction 172
Pain education groups 173
Where to go for help 175
Chapter 14. Other treatment strategies (TENS and acupuncture) 178
Acupuncture 178
Transcutaneous electrical nerve stimulation (TENS) 186
Acknowledgements 192
Bibliography 192
Chapter 15. Physiotherapy 194
Aims of treatment 194
Evaluation of the problem 195
Treatment strategies 196
Case history 198
Bibliography 202
Chapter 16. Organization of services in the pain clinic 204
Introduction 204
Pain clinics 205
In-patient pain management programmes 213
Conclusion 214
Bibliography 215
Appendix 216
Pain diary used in the Newcastle pain relief clinic 216
Index 218