Bulgarian Journal of Psychiatry, 2019; 4(4):40-47


Tatyana Telbizova, Hristo Kozhuharov

Department of Psychiatry and Medical Psychology, Medical University – Varna

Abstract. Pain and depression as a comorbidity that includes both the somatic and psychopathlogical symptoms is a widely spread phenomenon. There are proven connections on different levels that exist between them: neurobiological, (neuroanatomical, neurobiochemical and neuroendocrine), psychological and phenomenological. These levels of association correspond to the concept of the biopsychosocial model of the nature of the pain. Depression is a risk factor for the occurrence of disabilities, the worsening of the quality of life and the manifestation of autoaggressive behavior in patients with chronic pain. Oftentimes, the depressive symptoms among this group of patients remain unidentified or underestimated. In relation to this, the role of the psychiatrist as an expert in a multidisciplinary team for management and treatment of pain is crucial. Besides the clinical assessment of the depressive symptoms, an introduction of the phenomenological methods as a regular means is necessary. Delving into the essence of the experiences of patients, suffering from chronic pain, as well as into their analyses, would facilitate and improve the processes of personalized assessment, prognosis and choice of therapeutic behavior.

Key words: chronic pain, depression, comorbidity, biopsychosocial model, phenomenological analysis

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