Large R G
Aust N Z J Surg. 1978 Feb;48(1):113-5. doi: 10.1111/j.1445-2197.1978.tb05821.x.
The contribution of psychiatry to the evaluation and treatment of chronic pain is described. Psychological profiles may predict the outcome of surgery, while the psychiatric interview enhances understanding and may disclose formal psychiatric disorder. The measurement of pain is dependent on factors affecting pain complaint, and the psychiatrist can only accept the patient's experience. The reaction inhibition test and Chapman's Somatic, Anxiety, Depression (SAD) index provide ways of elucidating the functional versus organic dilemma. This is further understood by attention to the concepts of operant pain, the sick role, and illness behaviour. Psychotropic medications, psychotherapy, behaviour therapy, biofeedback, and distractional methods are the tools available to the psychiatrist. The patient's attitude and a combined physical and psychiatric approach are important for successful therapy.
本文描述了精神病学在慢性疼痛评估与治疗中的作用。心理特征可能预测手术结果，而精神科访谈有助于增进理解并可能揭示正式的精神障碍。疼痛的测量取决于影响疼痛主诉的因素，精神科医生只能接受患者的体验。反应抑制测试和查普曼躯体、焦虑、抑郁（SAD）指数提供了阐明功能性与器质性困境的方法。通过关注操作性疼痛、患病角色和疾病行为等概念，可以进一步理解这一点。精神药物、心理治疗、行为治疗、生物反馈和分散注意力的方法是精神科医生可用的工具。患者的态度以及物理与精神科相结合的方法对成功治疗至关重要。
