An Approach to Psychological Assessment of Chronic Pain Patient Evaluated for Implantable Devices

Abstract

Chronic pain is a multidimensional field in which a patient’s physical, environmental, and psychological state must be fully understood to further assess their problem. These variables form a complex interaction with each other and play a critical role in the treatment of chronic pain. The clinical interview is the cornerstone of the psychological evaluation. An important purpose of the interview is to identify any psychiatric conditions that might exacerbate pain or complicate treatment, such as psychosis, substance dependence, or a personality disorder. The patient was seen in the chronic pain clinic and assessed by the pain clinical psychologist. We present the case of a patient who presented to the chronic pain clinic and underwent evaluation for spinal cord stimulator trial placement. As part of this evaluation, the patient underwent psychological assessment by the pain clinical psychologist; we discuss the approach to psychological assessment using observational narrative. Psychological evaluation can help guide a physician’s treatment plan to better meet the patient’s needs. Psychological assessment prior to interventional management should be used as a tool to give the patient the best chance for success. Key words: Psychological assessment, psychological evaluation, spinal cord stimulation, intrathecal pump