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Pain clinics, a new role for psychiatrists: Results of a questionnaire survey of liaison psychiatrist involvement in pain clinics in the Greater London area

  • John Wallace (a1) and Gnanie Panch (a2)
Abstract
Aims and Method

The aim of this study was to find out the extent of psychiatric involvement in pain clinics and also clarify the treatment approaches taken for the significant psychiatric comorbidity reported in these clinics. A questionnaire survey was conducted, by a psychiatrist and an anaesthetist, of the 31 pain clinics in the Greater London area.

Results

Psychiatric involvement in the management of patients with chronic pain is extremely limited, despite the extensive psychiatric morbidity associated with these patients (response rate, 74%). The majority of surveyed pain clinics wish to provide a multi-disciplinary approach to these patients, utilising the skills of a psychiatrist for both assessment and management. Only a small minority of pain clinics, however, have sufficient access to a liaison psychiatry service that could provide the broad multi-disciplinary approach and the psychiatric treatment options that they believe chronic pain patients require.

Implications

The involvement of psychiatrists in pain clinics is very limited. Increased involvement is desired and would likely lead to an improved profile of pain clinics, a more realistic and comprehensive treatment approach and, in turn, enhanced patient care.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Degood, D. E. & Kiernan, B. (1996) Perception of fault in patients with chronic pain. Pain, 64, 153159.
Dolin, S. & Stephens, J. (1998) Pain clinics and liaison psychiatry. Anaesthesia, 53, 317319.
Geisser, M., Roth, R., Baehman, J., et al (1996) The relationship between symptoms of post traumatic stress disorder and pain, affective disturbance and disability in accident and non-accident related pain. Pain, 66, 207214.
Mayou, R., Anderson, H., Feinmann, C., et al (1990) The present state of consultation and liaison psychiatry. Psychiatric Bulletin, 14, 321325.
Romano, J. & Turner, J. (1985) Chronic pain and depression: does the evidence support a relationship? Psychology Bulletin, 97, 1832.
Royal College of Physicians & Royal College of Psychiatrists (1995) The Psychological Care of Medical Patients. Recognition of Need and Service Provision. Council Report CR35. London. Royal College of Physicians & Royal College of Psychiatrists.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Pain clinics, a new role for psychiatrists: Results of a questionnaire survey of liaison psychiatrist involvement in pain clinics in the Greater London area

  • John Wallace (a1) and Gnanie Panch (a2)
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