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Clinical Manual of Pain Management in Psychiatry

Raphael J. Leo, M.D.

  • ISBN 978-1-58562-275-7
  • Item #62275

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While recognizing the multidisciplinary nature of pain management, the Clinical Manual of Pain Management in Psychiatry focuses on the role of mental health practitioners in evaluation and assessment, pharmacological management, psychotherapeutic interventions, and comprehensive treatment planning. It balances theoretical foundations of pain pathophysiology with applied clinical information, providing guidelines to psychiatric differential diagnosis of pain states and psychiatric comorbidities associated with pain and integrating diagnostic and treatment approaches. Because proper treatment requires understanding the whole person, the book views the patient from biological, psychological, and social perspectives. It stresses the importance of examining psychological variables that can limit outcomes and even preclude aggressive interventional approaches. The manual also includes considerations pertinent to the elderly, children, and cultural groups.

This manual expands on the author's previous Concise Guide to Pain Management for Psychiatrists to reflect significant advances in the field of pain medicine. It updates trends in treatment approaches along with our understanding of chronic pain conditions, and presents new knowledge of the biological substrates underlying both pain and psychiatric comorbidities. The manual features particularly extensive revisions regarding the use of psychiatric and other adjunctive medications in pain management, including expanded discussion of long-term adverse effects, dependence, and pseudoaddictive behaviors involving opiates and weak analgesics. It also delineates the use of adjunctive treatments, including evolving data on the use of antidepressants and related medications for patients with chronic pain. Among the its practical benefits, the book

  • Features updated coverage of common psychiatric comorbidities such as depression, anxiety, and personality disorders
  • Addresses common pain disorders ranging from headache and back pain to pain related to cancer and HIV
  • Includes an extensively revised chapter on pharmacology, familiarizing readers with the range of pain medications and providing information on dosages and side effects
  • Fully discusses psychotherapeutic approaches, plus adjunctive interventions such as biofeedback and hypnosis
  • Covers special techniques such as acupuncture and regional neural blockade
  • Offers updated advice on emerging forensic issues, from disability claims to controlled substance diversion

With pain management issues so common in daily practice, this handy portable guide is designed for quick reference, features numerous tables and illustrations, and is easily understandable by less experienced clinicians or non-pain specialists. While written expressly for busy psychiatrists, it is also useful to psychologists, social workers, and other physicians.


  • List of Tables
  • List of Figures
  • Preface
  • Chapter 1. Introduction
  • Chapter 2. Sensory Pathways of Pain and Acute Versus Chronic Pain
  • Chapter 3. Evaluation of the Pain Patient
  • Chapter 4. Common Psychiatric Comorbidities and Psychiatric Differential Diagnosis of the Pain Patient
  • Chapter 5. Pharmacology of Pain
  • Chapter 6. Psychotherapy
  • Chapter 7. Special Techniques in Pain Management
  • Chapter 8. Common Pain Disorders
  • Chapter 9. Special Populations
  • Chapter 10. Forensic Issues Pertaining to Pain
  • Index

About the Authors

Raphael J. Leo, M.D., is Associate Professor at the State University of New York at Buffalo School of Medicine and Biomedical Sciences; and is a faculty member in both the Department of Psychiatry and the Center for Comprehensive Multidisciplinary Pain Management at Erie County Medical Center in Buffalo, New York.

The pain management literature is filled with contradictions and controversies. This book puts it all together in a coherent and understandable way. It can serve as a first reference for the clinician who seeks to understand almost any of the multitude of issues involved.—Jon Streltzer, M.D., Secretary, International College of Psychosomatic Medicine; Professor of Psychiatry, University of Hawaii, Honolulu, Hawaii

Dr. Leo has done it again! The Clinical Manual of Pain Management in Psychiatry concisely brings together the information psychiatrists must know to effectively manage people with pain. This book covers the underlying pathophysiology of pain, common pain syndromes, reasons for consultation with psychiatrist, role for pharmacotherapy and psychotherapy, and addresses the needs of special populations. Consultation-Liaison psychiatrists will appreciate the scope of the book, its attention to details, and its many tables and figures. General psychiatrists will find much included that is necessary for day to day practice.—B. Eliot Cole, M.D., M.P.A., Executive Director, American Society of Pain Educators, Montclair, New Jersey

Psychiatry offers a unique perspective on the formulation and treatment of patients with chronic pain. Dr. Leo demonstrates through his own experience and this new book that psychiatrists should take the lead in chronic pain management. Dr. Leo's latest contribution to the literature is a comprehensive review of the topics required to care for a patient with chronic pain. For psychiatrists interested in chronic pain, Dr. Leo lights the way with a book that should give them confidence about making a difference in the lives of patients suffering from these difficult disorders. Any reader will be spurred on to delve deeper into these very interesting topics—Michael R. Clark, M.D., M.Ph, Associate Professor & Director, Adolf Meyer Chronic Pain Treatment Programs, The Johns Hopkins Medical Institutions, Baltimore, Maryland

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