Physicians in the chronic pain field should participate in nosology and diagnostic criteria of medic

Physicians in the chronic pain field should participate in nosology and diagnostic criteria of medic

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最終更新日 2013年11月05日
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In fact, a diagnosis of medically unexplained pain (MUP) is quite confused. The most common cause of the confusion is that psychiatric fields and chronic pain fields independently determine nosology and diagnostic criteria of MUP without exchanging views. Patients with MUP are diagnosed with having somatoform disorder (somatization disorder and pain disorder) or adjustment disorder in psychiatric fields. Patients with MUP are diagnosed with having fibromyalgia, chronic widespread pain, or chronic regional pain. When diverse medical theories collide, the solution is easy. Medicine is not a science that ascertains whether a medical theory is correct or not. Rather, medicine is a science that pursues a better treatment outcome. We should choose the medical theory that provides a better treatment outcome. It is necessary to compare the treatment outcome between somatoform disorder and FM. Psychotherapy is effective for both disorders, but the greatest difference is in pharmacological therapy. FM has many drugs whose efficacy has been confirmed with a double-blind study; however, somatoform disorder lacks effective treatments.
It is hoped that the American Psychiatric Association develops nosology and diagnostic criteria with central sensitivity syndrome such as FM in mind and in conjunction with physicians in the chronic pain field. When Diagnostic and Statistical Manual of Mental Disorders (DSM)-6 is developed, the nosology and diagnostic criteria of medically unexplained pain should be decided with physicians in the chronic pain field.

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