Cheatle Martin D, Gallagher Rollin M
Behavioral Medicine Center, The Reading Hospital and Medical Center, P.O. Box 16052, Reading, PA 19612-6052, USA.
Curr Psychiatry Rep. 2006 Oct;8(5):371-6. doi: 10.1007/s11920-006-0038-7.
Chronic pain is a colossal health care problem that is devastating to the individual afflicted with unremitting pain and frustrating to the beleaguered health care provider attempting to adequately manage this multifaceted disease. The biopsychosocial model of pain management is a promising approach that emphasizes evidence-based medication management in conjunction with cognitive-behavioral therapy and a graded exercise program. The patient with chronic pain and concomitant mood and/or substance use disorders is exceptionally challenging. Effective pharmacologic management of pain and comorbid mood disorders, including the thoughtful use of opioids, can have a dramatic effect in improving the quality of life in patients with chronic pain. The high prevalence of chronic pain in our society and the scarcity of experienced pain medicine physicians necessitate the development of a community-based systems approach to this complex patient population.
慢性疼痛是一个巨大的医疗保健问题，对于遭受持续疼痛折磨的个体来说具有毁灭性，对于试图妥善管理这种多方面疾病的困扰的医疗保健提供者来说也令人沮丧。疼痛管理的生物心理社会模型是一种很有前景的方法，它强调基于证据的药物管理，同时结合认知行为疗法和分级运动计划。患有慢性疼痛以及伴有情绪和/或物质使用障碍的患者极具挑战性。对疼痛和共病情绪障碍进行有效的药物管理，包括谨慎使用阿片类药物，可对改善慢性疼痛患者的生活质量产生显著效果。在我们的社会中慢性疼痛的高患病率以及经验丰富的疼痛医学医生的稀缺，使得有必要针对这一复杂患者群体开发一种基于社区的系统方法。
