Borderline Personality Disorder Common in Chronic Pain Patients – MedScape – by Fran Lowry – Mar 2020
A significant proportion of patients who suffer from chronic pain also have features of borderline personality disorder (BPD), new research shows.
I really don’t know what to think about this because our healthcare system is so strongly biased against chronic pain patients and opioids that I don’t trust most of the research on it these days.
I can’t help but notice that it only says that pain patients “have features of” the disorder, but not that they have it. This is a sly way to make it sound like we all have BPD.
Unfortunately, those of us who don’t have a straight forward diagnosable and curable disease require more time and effort from our “healthcare providers” than many other patients, and this makes us a “burden” to the average over-scheduled metric-managed doctor.
Even maintenance pain management is an ongoing chore to balance different pharmaceuticals (opioid and non-opioid medications) to maximize functionality while limiting side effects and tolerance.
Worse, because our pain can rarely be cured, all the doctor’s work can’t save us, and this inability to “fix” our health issue leaves them (and us) frustrated.
Results of a systematic literature review showed 23% of patients with chronic noncancer pain (CNCP) had some features of BPD, including difficulty maintaining relationships as well as affect and mood instability.
“The fact that one fourth of individuals with CNCP could have co-occurring BPD underscores the need for improved access to good psychological care,” lead investigator Fei Cao, MD, PhD, University of Missouri at Kansas City, told Medscape Medical News.
Cao noted that a “significant number” of CNCP patients have at least some resistance to any type of pain treatment and speculated that BPD may increase treatment-resistant chronic pain.
The phrase “patients have at least some resistance to any type of pain treatment” grammatically means that pain patients are the ones putting up resistance. What they “meant to say” is that our pain is resistant to treatment, not we ourselves.
Careless grammar always seems to favor the wrong interpretation of scientific articles. I suspect it’s because the reviewer fundamentally believes pain patients aren’t “really sick” and that if we’d just stop “catastrophizing” we’d be fine.
Initially an anesthesiologist and pain medicine specialist, Cao later became a psychiatrist after recognizing the importance of addressing the underlying psychological needs of patients with chronic pain.
He noted that there is a strong psychological component to chronic pain and that many patients with chronic pain have suffered psychological trauma.
Indeed, the medical system has subjected many of us to trauma when our desperate cries for help with our pain fell on the deaf ears of doctors who believed all the anti-opioid PROPaganda (to which this study will undoubtedly be added).
The implication is that it’s our “psychological trauma” that brings about our pain.
To gain a better understanding of the prevalence of BPD in patients suffering from chronic pain and potentially provide some unexploited targets for chronic pain management, the investigators analyzed data from 11 studies published between 1994 and 2019.
They found the prevalence of BPD among CNCP patients was 23.3%.
Pain types included
- chronic headache (11.3%),
- arthritis (27.5%), and
- chronic spinal cord pain (24.3%).
Screen for BPD
The study findings, he added, indicate a need to screen for BPD in patients with chronic pain.
Interventions that are effective in the treatment of BPD and CNCP include
- cognitive behavioral therapy,
- dialectical behavior therapy,
- antidepressants, and
And below is another article about the same abstract, which continues implicating patients’ mental problems, specifically BPD, in their own pain:
Prevalence of Borderline Personality Complicates Pain Management – Pain Medicine News – by Kenneth Bender – May 2020
My next post will address the referenced abstract itself – and it’s a doozy…