Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11)

Pain - Tập 160 Số 1 - Trang 19-27 - 2019
Rolf‐Detlef Treede1, Winfried Rief2, Antonia Barke2, Qasim Aziz3, Mike Bennett4, Rafael Benoliel5, Milton Cohen6, Stefan Evers7, Nanna Brix Finnerup8,9, Michael B. First10, Maria Adele Giamberardino11, Stein Kaasa12,13,14, Beatrice Korwisi2, Eva Kosek15, Patricia Lavand’homme16, Michael K. Nicholas17, Serge Perrot18, Joachim Scholz19, Stephan A. Schug20,21, Blair H. Smith22, Peter Svensson23,24, Johan W.S. Vlaeyen25,26,27,28,29, Shuu‐Jiun Wang3,2
1Medical Faculty Mannheim of Heidelberg University, Mannheim, Germany
2Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany
3Centre for Neuroscience and Trauma, Wingate Institute of Neurogastroenterology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, United Kingdom
4Academic Unit of Palliative Care, University of Leeds, Leeds, United Kingdom
5Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Rutgers, Newark, NJ, United States
6St Vincent's Clinical School, UNSW, Sydney, New South Wales, Australia
7Department of Neurology, Krankenhaus Lindenbrunn, Faculty of Medicine, University of Münster, Münster, Germany
8Department of Clinical Medicine, Danish Pain Research Center, Aarhus University, Aarhus, Denmark
9Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
10Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, United States
11Department of Medicine and Science of Aging, CeSI-MeT, G D'Annunzio University of Chieti, Chieti, Italy
12Department of Oncology, Oslo University Hospital, Oslo, Norway
13European Palliative Care Research Centre (PRC)
14University of Oslo, Oslo, Norway
15Department of Clinical Neuroscience, Karolinska Institute, and Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
16Department of Anesthesiology, Acute Postoperative Pain Service, Saint Luc Hospital, Catholic University of Louvain, Brussels, Belgium
17University of Sydney Medical School, Sydney, Australia
18Pain Clinic, Hotel Dieu Hospital, Paris Descartes University, Paris, France
19Departments of Anesthesiology and Pharmacology, Columbia University, New York, NY, United States
20Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, Australia
21Discipline of Anaesthesiology and Pain Medicine, Medical School, University of Western Australia, Perth, Australia
22Division of Population Health and Genomics, University of Dundee, Scotland
23Department of Dental Medicine, Karolinska Institute, Huddinge, Sweden
24Section of Clinical Oral Physiology, School of Dentistry, Aarhus University, Aarhus, Denmark
25Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
26Research Group Health Psychology, University of Leuven, Leuven, Belgium
27Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.
28Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com).
29TRACE, Center for Translational Health Research, KU Leuven, Ziekenhuis Oost-Limburg, Genk, Belgium

Tóm tắt

Abstract

Chronic pain is a major source of suffering. It interferes with daily functioning and often is accompanied by distress. Yet, in the International Classification of Diseases, chronic pain diagnoses are not represented systematically. The lack of appropriate codes renders accurate epidemiological investigations difficult and impedes health policy decisions regarding chronic pain such as adequate financing of access to multimodal pain management. In cooperation with the WHO, an IASP Working Group has developed a classification system that is applicable in a wide range of contexts, including pain medicine, primary care, and low-resource environments. Chronic pain is defined as pain that persists or recurs for more than 3 months. In chronic pain syndromes, pain can be the sole or a leading complaint and requires special treatment and care. In conditions such as fibromyalgia or nonspecific low-back pain, chronic pain may be conceived as a disease in its own right; in our proposal, we call this subgroup “chronic primary pain.” In 6 other subgroups, pain is secondary to an underlying disease: chronic cancer-related pain, chronic neuropathic pain, chronic secondary visceral pain, chronic posttraumatic and postsurgical pain, chronic secondary headache and orofacial pain, and chronic secondary musculoskeletal pain. These conditions are summarized as “chronic secondary pain” where pain may at least initially be conceived as a symptom. Implementation of these codes in the upcoming 11th edition of International Classification of Diseases will lead to improved classification and diagnostic coding, thereby advancing the recognition of chronic pain as a health condition in its own right.

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Tài liệu tham khảo

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Pain

Tập 160 Số 1

19-27

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