THE PROBLEM-ORIENTED PSYCHIATRIC-EXAMINATION OF THE CHRONIC PAIN PATIENT AND ITS APPLICATION TO THE LITIGATION CONSULTATION

Objective: The purpose of this paper is (a) to delineate the behavior problems or complaints of chronic pain patients (CPPs) as presented in the literature and to add those behavior problems that have not yet b een identified; (b) to present a semistructured psychiatric interview format that would lead to the delineation of these problems; and (c) t o present a format and structure for the proposed semistructured psych iatric interview that could be utilized for the purposes of medicolega l assessment of the CPP and the reporting of that assessment to the li tigation process. Setting: Any psychiatric/psychological examination o f the CPP. Methods: The pain literature was reviewed for any research reports that specifically addressed or delineated the types of behavio r problems found within the chronic pain (CP) population. These behavi or problems were placed in a semistructured interview format, organize d in such a way as to facilitate reporting to the litigation process i f necessary. Results: This semistructured psychiatric examination form at is presented. Controversial problem areas in this format are discus sed with appropriate references. Conclusions: CPPs are seen for the ps ychiatric examination with a set of behavioral problems largely determ ined by their medical condition, the consequences of that condition, a nd the social circumstances surrounding that medical condition (e.g., the litigation process). The psychiatric examination should be tailore d to this special set of problems.