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Pain disorder

Pain disorder
Classification and external resources
ICD-9-CM 307.89
MeSH D013001
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Pain disorder is chronic pain experienced by a patient in one or more areas, and is thought to be caused by psychological stress. The pain is often so severe that it disables the patient from proper functioning. Duration may be as short as a few days or as long as many years. The disorder may begin at any age, and occurs more frequently in girls than boys. This disorder often occurs after an accident or during an illness that has caused pain, which then takes on a 'life' of its own.

The DSM-IV-TR specifies three coded subdiagnoses: pain disorder associated with psychological factors, pain disorder associated with both psychological factors and a general medical condition and pain disorder associated with a general medical condition (although the latter subtype is not considered a mental disorder and is coded separately within the DSM-IV-TR). Conditions such as dyspareunia, somatization disorder, conversion disorder, or mood disorders can eliminate pain disorder as a diagnosis. Diagnosis depends on the ability of physicians to explain the symptoms and on psychological influences.

Common symptoms of pain disorder are: negative or distorted cognition, such as feelings of despair or hopelessness; inactivity and passivity, in some cases disability; increased pain, sometimes requiring clinical treatment; sleep disturbance and fatigue; disruption of social relationships; depression and/or anxiety. Acute conditions last less than six months while chronic pain disorder lasts six or more months. There is no neurological or physiological basis for the pain. Pain is reported as more distressing than it should be if there was a physical explanation. People who suffer from this disorder may begin to abuse medication.

At least once a week, 10-30% of those under 18 years of age suffer from unexplainable headaches and abdominal pains in the United States, and the number is rising. People from collectivistic countries such as Japan, China, and Mexico are more likely to suffer from pain disorder than individualistic countries such as the US and Sweden.

Ethnicities show differences in how they express their discomfort and on how acceptable shows of pain and its tolerance are. Most obvious in adolescence, females suffer from this disorder more than males, and females reach out more. More unexplainable pains occur as people get older. Typically, younger children complain of only one symptom, commonly abdominal pains or headaches. The older they get, the more varied the pain location as well as more locations and increasing frequency.


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