139 Pain Disorder (307)
DSM-IV-TR criteria
A. Pain in one or more anatomical sites is the predominant focus of the clinical presentation and is of sufficient severity to warrant clinical attention.
B. The pain causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. Psychological factors are judged to have an important role in the onset, severity, exacerbation, or maintenance of the pain.
D. The symptom or deficit is not intentionally produced or feigned (as in Factitious Disorder or malingering).
E. The pain is not better accounted for by a Mood, Anxiety, or Psychotic Disorder and does not meet criteria for Dyspareunia.
Code as follows:
307.80 Pain Disorder Associate With Psychological Factors: psychological factors are judged to have the major role in the onset,severity, exacerbation, or maintenance of the pain. (If a general medical condition is present, it does not have a major role on the onset,severity, exacerbation, or maintenance of the pain.) This type of Pain Disorder in not diagnosed if criteria are also met for Somatization Disorder.
Specify if:
- Acute: duration of less than 6 months
- Chronic: duration of 6 months or longer
- 307.89 Pain Disorder Associated with both psychological factors and general medical condition: both psychological factors and a general medical condition are judged to have important roles in the onset, severity, exacerbation, or maintenance of the pain. The associated general medical condition or anatomical site of the pain(see below) is coded on Axis III
Specify if:
- Acute:duration of less than 6 months
- Chronic: duration of 6 months or longer
Note: The following is not considered to be a mental disorder and is included here to facilitate differential diagnosis.
Pain Disorder Associated with a General Medical Condition: a general medical condition has a major role in the onset, severity, exacerbation, or maintenance of the pain. (If psychological factors are present, they are not judged to have a major role in the onset, severity, exacerbation, or maintenance of the pain.) The diagnostic code for the pain is selected based on the associated general medical condition if one has been established(see Appendix G) or on the anatomical location of the pain if the underlying general medical condition is not yet clearly established-for example, low back(724.2) sciatic (724.3), pelvic (625.9), headache (784.0), facial (784.0), chest (786.5), joint (719.4), bone (733.9), abdominal (789.0), breast (611.71), renal(788.0), ear (388.70), eye (379.91), throat(784.1), tooth (525.9), and urinary (788.0).
Associated features
Pain may severely disrupt different aspects of a person’s daily life. It may lead to unemployment, disability, and family problems. It may also have an effect on Iatrogenic Opiod Dependence or Abuse and Benzodiazepine Dependence or Abuse as well as Substance Dependence or Abuse. It is also associated with severe depression with terminal ill