Pain
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Two hundred and eighty-three chronic pain patients, consecutive admissions to the Comprehensive Pain Center of the University of Miami School of Medicine, received an extensive psychiatric evaluation based upon the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (DSM-III) criteria and flowsheets. All patients received the following type of diagnoses: DSM-III axis I; DSM-III axis II, and personality type. The distribution of assigned diagnoses for the entire patient sample was reviewed and a statistical comparison between male and female patients was performed with regards to the prevalence of each diagnosis. ⋯ All personality types were similarly distributed between the sexes. The results of the present study were compared to a previous study of DSM-III diagnoses in chronic pain patients and are discussed in terms of the prevalence of DSM-III diagnoses in the general population. Questions are raised as to the applicability of certain DSM-III diagnoses in the chronic pain population.
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Case Reports
Substance dependence and chronic pain: profile of 50 patients treated in an alcohol and drug dependence unit.
Fifty adult patients with chronic pain and substance dependence were admitted to an inpatient unit for treatment of addiction without primary emphasis on treatment of pain. As a group they had received considerable medical attention for their pain, but relatively little for their addictions. When compared with a group of general medical patients, the study population showed MMPI evidence of considerably more psychopathologic characteristics. MMPI data and family histories of substance dependence did not differentiate the study group from a comparable group in a Pain Management Center.