25. September 2018

Emotional Dimensions of Chronic Pain

Prof. Anne-Françoise Allaz Service de Médecine Interne de Réhabilitation Beau-Séjour, Département de Médecine Interne Réhabilitation et Gériatrie, Hopitaux Universitaires de Genève

 

In general internal medicine, persistent chronic pain is very prevalent. Its intensity or its consequences remain often largely unexplained by somatic findings. The modulation of chronic pain by emotions, in particular by depression and anxiety is today widely accepted and confirmed by discoveries in neurosciences. Contemporary integrative models take into account patients’ personal vulnerabilities such as trauma history and affect regulation disorder. Somatisation is observed in all age cohorts. Moreover, such dimensions as «catastrophism», perceived injustice and anger represent targets for therapy in chronic pain patients. Chronic pain is also part of a social nexus and often represents a message conveying a call for identity, attention and understanding. Interpersonal dimensions are receiving renewed interest. The doctor-patient relationship and therapeutic alliance are therefore central for the care of the complex patients suffering from chronic pain although the encounter may be challenging for the primary-care physicians. A comprehensive practice based approach will be proposed to discussion.

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