Wanted: Pain Training in Psychiatry

Chronic pain is a public health problem of pandemic proportions that affects more than 70 million Americans. It’s among the most common concerns for healthcare professionals, and the annual costs associated with chronic pain have been estimated at approximately $100 billion due to medical expenses, as well as loss of earnings and productivity. Studies estimate that about 50% of community-dwelling elderly people and as many as 80% of nursing home residents experience chronic pain. One of the most daunting challenges for psychiatric professionals is to distinguish physical and emotional symptoms that patients experience in the context of pain. Despite the fact that the physical and psychological aspects of pain are closely linked, surprisingly few pain-related themes are included in psychiatric residency training. According to current demographic trends, there appears to be a shortage of pain experts, further complicating care for patients. There will be a greater need for training in pain management, especially as the overall proportion of geriatric patients continues to increase. Older individuals, in particular, are at higher risk for developing pain-related conditions.  Analyzing Current Trends of Pain Management Education In a review article published in the January 2011 Archives of Internal Medicine, my colleagues and I assessed why it’s important to teach pain management to psychiatrists. A central theme of our article was that pain education should be an integral part of the core curriculum of psychiatric residency programs. A wide range of psychiatric conditions are associated with heightened pain prevalence, including major depressive disorder, borderline personality disorder, addictions, and PTSD. Since pain is exceedingly prevalent in psychiatric patients, psychiatrists will be faced with increasing numbers of...