Multiple Assessments for Chronic Pain : For Clarification of the Treatment Objects(Symposium/The Mechanism and Practice of Chronic Pain)

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  • Hosoi Masako
    Department of Psychosomatic Medicine, Kyushu University Hospital
  • Kubo Chiharu
    Department of Psychosomatic Medicine, Kyushu University Hospital

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Other Title
  • 慢性疼痛の多面的評価 : 治療対象の明確化のために(シンポジウム:慢性疼痛の基礎と臨床,2008年,第49回日本心身医学会総会(札幌))
  • 慢性疼痛の多面的評価--治療対象の明確化のために
  • マンセイ トウツウ ノ タメンテキ ヒョウカ チリョウ タイショウ ノ メイカクカ ノ タメニ

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Background: Clinical medicine on chronic pain conceives several important problems including invalid managements, disabled quality of life for patients and their families, dysfunctional medical communication, and raised medical socio-economical costs. The International Association for the Study of Pain has proposed the IMMPACT recommendations as an international consensus for clinical pain research in 2003 and 2005. Following this guideline, we overview the multiple assessments for chronic pain in Japan. Methods: We investigated and modified the IMMPACT recommendation for Japanese pain medicine. From the clinical experience for severe chronic pain patients in the Department of Psychosomatic Medicine in Kyushu University Hospital, we specified the several important treatment objects and multiple assessments for the psychosomatic treatment. Results: We introduce the original IMMPACT recommendation and proposed the eleven axes of multiple assessments for Japanese chronic pain patients (pain intensity, pain disability, anxiety・depression・catastrophizing, alexithymia, organic and functional disorder, personality trait・personality disorder・mental retardation, psychiatric disorder, pain behavior, cognition and coping for pain, dysfunctional communication with family or society, medical disbelief) for clarification of psychosomatic treatment objects such as medical disbelief, catastrophizing, pain behavior, alexithymia, pacing disorder and discommunication with significant others. Conclusions: We propose the importance of multiple assessments for clarification of psychosomatic treatment objects. However, the systematic assessments for chronic pain are still on the way to development and need more attention from psychosomatic clinicians and researchers for future development.

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