Treatment of the Patient Complicated by Psychiatric Illness

Beth Boyarsky, MD, PhD

Psychiatrist
Albany Medical Center
Albany, New York

Patients with chronic pain often present with comorbid psychiatric disorders. Interestingly, similar neurotransmitter systems have been implicated in chronic pain and such psychiatric disorders as major depressive disorder and generalized anxiety disorder. When treating chronic pain, clinicians should be aware that certain psychiatric pathologies place patients at greater risk for aberrant opioid-related behaviors, highlighting the need for a comprehensive risk assessment based on a Universal Precautions approach. Successful treatment of these patients will be facilitated by appropriate referral and a coordinated multidisciplinary approach.

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