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Chronic pain, psychopathology, and DSM-5 somatic symptom disorder

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dc.contributor.authorKatz, Joel
dc.contributor.authorRosenbloom, Brittany, N.
dc.contributor.authorFashler, Samantha, R.
dc.date.accessioned2016-11-16T14:49:21Z
dc.date.available2016-11-16T14:49:21Z
dc.date.issued2015-04
dc.description.abstractUnlike acute pain that warns us of injury or disease, chronic or persistent pain serves no adaptive purpose. Though there is no agreed on definition of chronic pain, it is commonly referred to as pain that is without biological value, lasting longer than the typical healing time, not responsive to treatments based on specific remedies, and of a duration greater than 6 months. Chronic pain that is severe and intractable has detrimental consequences, including psychological distress, job loss, social isolation, and, not surprisingly, it is highly comorbid with depression and anxiety. Historically, pain without an apparent anatomical or neurophysiological origin was labelled as psychopathological. This approach is damaging to the patient and provider alike. It pollutes the therapeutic relationship by introducing an element of mutual distrust as well as implicit, if not explicit, blame. It is demoralizing to the patient who feels at fault, disbelieved, and alone. Moreover, many medically unexplained pains are now understood to involve an interplay between peripheral and central neurophysiological mechanisms that have gone awry. The new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, somatic symptom disorder overpsychologizes people with chronic pain; it has low sensitivity and specificity, and it contributes to misdiagnosis, as well as unnecessary stigma. Adjustment disorder remains the most appropriate, accurate, and acceptable diagnosis for people who are overly concerned about their pain.en_US
dc.description.sponsorshipPreparation of this manuscript was facilitated by support from a Canadian Institutes of Health Research (CIHR) Canada Research Chair in Health Psychology awarded to Dr Katz and a CIHR Canada Graduate Master’s Award to Samantha Fashler.
dc.identifier.citationKatz, J., Rosenbloom, B.N., & Fashler, S. (2015). Chronic pain, psychopathology, and DSM-5 somatic symptom disorder. Canadian Journal of Psychiatry, 60(4), 160-167
dc.identifier.issn0706-7437 (Print), 1497-0015 (Online)
dc.identifier.urihttp://hdl.handle.net/10315/32586
dc.language.isoenen_US
dc.publisherSAGE Publicationsen_US
dc.rights.articlehttp://cpa.sagepub.com/content/60/4/160.abstract
dc.rights.journalhttp://cpa.sagepub.com/en_US
dc.rights.publisherhttp://online.sagepub.com/en_US
dc.subjectchronic pain, central sensitization, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), somatic symptom disorder, emotional distress, medically unexplained pain, psychological factorsen_US
dc.titleChronic pain, psychopathology, and DSM-5 somatic symptom disorder
dc.typeArticleen_US

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