Psychiatry has much to offer for chronic pain

Objective: The objective of this study was to make an argument in favour of the inclusion of psychiatrists on chronic pain clinic teams. Method: The argument takes the form of answers to four central questions: (i) does pain involve an emotional experience; (ii) do psychiatric disorders accompany chronic pain; (iii) can psychiatric disorders present as chronic pain; and (iv) which patients present to pain units, and what do we know of their personalities? Results: The affirmative case was substantiated in respect of the first three questions. In examining the last question, evidence indicates that patients who present to chronic pain units frequently have personality features that make assessment and therapy difficult. Conclusions: Psychiatry is the field of medicine where practitioners have the most experience with emotional states and personality, and is the only field where they have specialized skills in the diagnosis and treatment of psychiatric disorders. Psychiatry has much to offer in chronic pain management and chronic pain management teams should include a psychiatrist. This conclusion has resourcing and training implications.