Current opinion in psychiatry
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Curr Opin Psychiatry · Jul 2008
ReviewThe impact of stigma on somatic treatment and care for people with comorbid mental and somatic disorders.
The problems associated with high rates of medical comorbidities among people with mental disorders have multidimensional consequences, including the challenge of their management. The stigma on the treatment of these complex situations is the focus of this review. The time span and context of the review are set to cover the period from 2006 to the present; the review includes related themes of stigma. ⋯ The stigma attached to mental disorders in general forms the basis of the stigma towards the physical health problems of these patient groups. The impact of stigma on somatic treatment and care for people with comorbid mental and somatic disorders is discussed in its context as a public-health problem. Integrative services, and optimism and hope in health professionals are essential factors in reducing such stigma, and hence in enhancing better healthcare.
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The present review focuses on the co-occurrence of substance use disorder and post-traumatic stress disorder, with special attention to measurement and the role of violence as a contributor to the comorbidity. ⋯ Lack of consistency in terms of substance use classification and measurement of post-traumatic stress disorder across studies continues to hinder comparisons of rates of comorbid substance use disorder and post-traumatic stress disorder. More attention to the role of violence as a contributor to the comorbidity and its impact on treatment outcomes is warranted.
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Curr Opin Psychiatry · Mar 2008
Redefining (somatoform) pain disorder in ICD-10: a compromise of different interest groups in Germany.
Pain is one of the most frequent reasons to visit health professionals. Many patients suffering from chronic pain conditions not only need medical treatment but also psychiatric or psychological interventions. This additional treatment need should be underlined using an ICD section F diagnosis. The current ICD-10 diagnosis of somatoform pain disorder requests psychological causation of the pain, which is frequently unclear or difficult to decide. ⋯ A diagnosis of pain disorder is necessary to underline the additional need of psychiatric/psychological interventions in chronic pain conditions. This diagnosis should include psychological features that are relevant for development or maintenance of chronic pain. In contrast to earlier attempts of redefining pain diagnoses, our attempt included representatives of the association for the study of pain.