[Psychological components of chronic pain in the elderly]

Chronic pain is a complex multidimensional phenomenon. Pain complaints in the elderly are modulated by several psychosocial factors. They can be understood as a way to indicate suffering or to get attention and sometimes as a mean to regain self-esteem. There is little quantitative change in pain associated psychopathology and coping mechanisms in the elderly as compared to younger patients. However, qualitative changes are identified. The high degree of association between chronic pain and depression remains throughout the age span. However, age variations in the expression of psychological distress are to be noted. Elderly patients have a tendency to make a greater use of somatic complaints and avoid the expression of the emotional dimension of distress. This clinical particularity is discussed. Special attention should be paid to the multidimensional aspects of pain complaints in the elderly in order not to underestimate its affective components.