Abstract
The psychiatrist who manages patients with chronic pain has two major roles ; psychiatric consultation and psychiatric treatment. The process and technique used in psychiatric consultations with chronic pain patients is discussed. When there has been a negative medical and surgical examination, it is the task of the psychiatrist to evaluate the patient for psychological components to his pain rather than to assume the existence of "psychogenic" pain. Accurate communication with. the referring physician about any psychiatric components, without premature judgment for the "cause of the pain, " is most important. Pain management programs based on the operant conditioning theory are more increasingly accepted in the treatment of patients with chronic pain. Utilizing a report on the first 200 patients treated at the Pain Management Center at Mayo Clinic, the content of a pain management program is discussed. Potential difficulties which might be encountered in the application of a pain management program in Japan are also discussed.
