Differentiating and managing common psychiatric comorbidities seen in chronic pain patients

Pain patients often have comorbid psychiatric disorders that can complicate their management. Failure to recognize and address psychological comorbidities often limits pain treatment success. This paper describes some of the more commonly seen psychiatric comorbidities in pain patients, briefly discusses how the diagnoses are made, and provides some initial treatment guidelines. The multiaxial diagnostic system of the Diagnostic and Statistical Manual of Mental Disorders (DSM) is described. Three common psychiatric issues seen in pain patients: anxiety, depression, and adjustment disorder, are discussed. A brief history of the DSM is also discussed.