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

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    Rolf-Detlef Treede, Medical Research Center, University Hospital Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany., Winfried Rief, Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany., Antonia Barke, Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany., Qasim Aziz, Centre for Neuroscience and Trauma, Wingate Institute of Neurogastroenterology, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom., Michael I Bennett, Academic Unit of Palliative Care, University of Leeds, Leeds, United Kingdom., Rafael Benoliel, Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Newark, NJ, United States., Milton Cohen, St Vincent's Clinical School, UNSW, Sydney, New South Wales, Australia., Stefan Evers, Department of Neurology, Krankenhaus Lindenbrunn, Faculty of Medicine, University of Münster, Münster, Germany.,
  • Nanna Brix Finnerup
  • Michael B First, Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, United States., Maria Adele Giamberardino, Department of Medicine and Science of Aging, CeSI-MeT, G D'Annunzio University of Chieti, Chieti, Italy., Stein Kaasa, Oslo University Hospital, Norway University of Oslo, Norway., Beatrice Korwisi, Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University Marburg, Marburg, Germany., Eva Kosek, Department of Clinical Neuroscience, Karolinska Institute, and Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden., Patricia Lavandʼhomme, Department of Anesthesiology and Acute Postoperative Pain Service, Saint Luc Hospital, Catholic University of Louvain, Brussels, Belgium., Michael Nicholas, Sydney Medical School, University of Sydney, Australia., Serge Perrot, Pain Clinic, Hotel Dieu Hospital, Paris Descartes University, Paris, France., Joachim Scholz, Departments of Anesthesiology and Pharmacology, Columbia University, New York, NY, United States., Stephan Schug, Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, Australia., Blair H Smith, Division of Population Health and Genomics, University of Dundee, Dundee, Scotland.,
  • Peter Svensson
  • Johan W S Vlaeyen, Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands., Shuu-Jiun Wang, Brain Research Center and Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.

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.

OriginalsprogEngelsk
TidsskriftPain
Vol/bind160
Tidsskriftsnummer1
Sider (fra-til)19-27
Antal sider9
ISSN0304-3959
DOI
StatusUdgivet - jan. 2019

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