Additive
psychiatric diagnoses (such as depression)
According to
the concept of "disability pain" somatoform pain syndrome is
characterized by a pattern of less typical symptoms, but with a certain
experience of physical processing operations ("suffering") and the
unfavorable behavior stakeholders disease ("abnormal illness
behavior").
Three types
of psychological factors in the initiation and maintenance of pain is very important:
(a) katastrophisierendes think, (b) anxiety-related pain and fear of pain, (c)
a feeling of helplessness. Chronically ill patients learn to cope with using
pain cope with their pain, as well as those who accept their pain and not
constantly fight it, less affected, depression and anxiety.
Pain
disorders often occur in conjunction with other mental disorders (depression,
anxiety disorders, post-traumatic stress disorder, sleep disorders). After
cross-country WHO study of pain in primary care practice, 34% of patients
experiencing pain depression or anxiety disorders. In a psychiatric hospital
patient's pain may occur more frequently (to the level of 87% of inpatients).
Pain is often
the only symptom of depression or at least presented as the main symptom.
Chronic pain is often associated with depression, acute pain, but not with
anxiety disorders. Sleep problems usually arise in a decrease in the period and
phase 3 and 4 (sleep) REM, that is, the most important stages and most restful
sleep.
Proven by
many studies are frequently comorbid depression and pain showed that both
countries suffer often not for causal models can be explained, but is caused by
a third general, psychosocial stress is large in partnership, family, work, and
community. Biological factors, such as the serotonergic system disorders that
are relevant not only in depression, but also for the modulation of pain is
also significant. Patients also suffer under pain disorders and depression are
more affected and seek medical care facilities more often than others that have
only one of these two disorders. 60% of patients have experienced trauma pain.
Every second
pain patients suffer simultaneously from anxiety disorders. Many patients with
somatoform pain disorder have a history of functional complaints, such as
gastrointestinal or cardiovascular problems.
What is
important is the difference of somatization disorder, where even a different
experience pain, but compared with other symptoms are not so persistent and
especially as a somatoform pain disorder. Persistent somatoform pain disorder
can not be diagnosed in the sense of comorbidity Therefore, if the pain is only
in the context of somatization disorder, undifferentiated somatoform disorder
or somatization autonomic dysfunction (eg irritable bowel syndrome) occurs. The
same thing applies sick, as often occurs in the context of major depressive
episode (F32 and F33), and pain associated with neurasthenia or fatigue
syndrome (F48.0), which is also an acute or chronic muscle pain one of six
additional symptoms occur could.
According to
the Health Survey 1998 8:14% of Germans have a pain disorder in a year and
12.74% in life - women twice as often as men. Consistent results from different
studies to conclude that at least one in ten suffers from chronic pain Germany,
in which psychological factors and social tend to have at least some influence.
At the top is a headache and backache. According to conservative estimates of
experts tend to play an important role in the development, initiation and
maintenance of pain associated with psychological factors of persistent pain in
40% of patients. Although pain disorder can occur in all age groups, however,
are found most often in the decade of the 4th and 5th of life. Pronounced
gender difference is not known.
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