Pain and psychiatry: a critical analysis and pharmacological review

Donatella Marazziti¹ , Francesco Mungai¹ , Laura Vivarelli¹ , Silvio Presta¹ and Bernardo Dell'Osso²^,3

¹Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Italy

²Compulsive, Impulsive and Anxiety Disorders Program, Department of Psychiatry, Mount Sinai School of Medicine, New York, NY, USA

³Department of Psychiatry, Institute of Biomedical Sciences, Hospital "L. Sacco", University of Milan, Via G.B. Grassi 74, 20157, Milan, Italy

author email corresponding author email

Clinical Practice and Epidemiology in Mental Health 2006, 2:31doi:10.1186/1745-0179-2-31


Published:	6 November 2006

Abstract

Pain is one of the most difficult medical problems to diagnose and treat and can be a common symptom of several psychiatric disorders. Pain-related issues are heterogeneous and often underestimated or misinterpreted, with the result that psychiatric interventions, which might have been beneficial from the outset, are often delayed or requested only as a last measure. Several problems arise from the definition, classification and assessment of pain, when documented according to the different scales which are commonly used, since these attempt to cover a multitude of analytical requirements, without really succeeding. An area of constant debate regards the connection between pain and various psychiatric disorders, and the difficulty in the classification of pain disorders within the currently existing framework. The pharmacological treatment of pain is complex and implies a variety of different compounds, from opioids to psychotropic medications like antidepressants and anticonvulsivants.

This paper explores the mutual and reciprocal influence between pain and psychiatric disorders reviewing the latest developments in the definition, assessment and treatment of pain, with special emphasis on the impact of pain on psychiatric disorders (and vice versa), and on the use of psychotropic drugs in the treatment of pain syndromes.