Incorporating pain management training into the psychiatry residency curriculum.

Pain management has received increased attention from the medical community, influenced by societal demands for more effective and comprehensive treatment. In fact, the Joint Commission on Accreditation of Health Care Organizations requires that physicians consider pain as "the fifth vital sign." It requires that pain severity be documented by using a standardized pain scale. Unfortunately, the assessment and management of pain is difficult. Pain is more than a sensation; it is influenced by emotional, cognitive, and psychosocial factors. The role of the psychiatrist in managing patients with pain has received increasing attention. The American Board of Psychiatry and Neurology now offers a subspecialty certification in Pain Management. While certification is warranted for those who practice extensively in this area, the general psychiatrist should also have familiarity with those issues that are likely to arise in treating patients with pain. Toward this end, the following guidelines are proposed for pain management training to be incorporated into the residency training curriculum.