Southern Medical Journal CME Topic: psychosomatic pain: new insights and management strategies.

Need

Treating unexplainable chronic pain can be highly challenging for physicians when it is associated with significant nonanatomic or psychogenic features. Chronic pain patients tend to have an increased incidence of emotional, physical and/or sexual abuse and often develop syndromes including posttraumatic stress disorder, fibromyalgia, and other conditions characterized by repression, somatization, and increased utilization of medical care. Clinicians should routinely ask such patients about any history of past or present abuse, and carefully observe and document dysfunctional behaviors during the physical examination that may provide important evidence of psychogenic disease.

Target Audience

The following CME feature was designed for physicians in all specialties, particularly those in primary care.

Purpose and Objectives

After completing this activity, participants should be familiar with the various classifications of pain, the psychological aspects associated with chronic pain, the physiological aspects of abuse and psychogenic disease, evaluation and observation methods for behavorial patterns in patients with chronic pain, methods of management for particularly challenging patients, as well as various treatment options for chronic pain sufferers.

Disclosure of Relevant Financial Relationships

The Accreditation Council for Continuing Medical Education's (ACCME) Standards for Commercial Support approved in September 2004 require that the provider (Southern Medical Association) show that anyone who is in a position to control the content of an education activity has disclosed all relevant financial relationships with any commercial interest to the provider. A relevant relationship is defined as financial relationships in any amount occurring within the past twelve months that create a personal conflict of interest. The disclosure must include the name of the individual, the name of the commercial interest and the nature of the relationship. Individuals with "no" relevant financial relationship(s) must also disclose to the learner prior to the activity. Any individual involved in planning CME Activities who does not comply with this policy will not be permitted to have control of, or responsibility for, the development, management, or evaluation of SMA's CME Activity. Resolution of conflict of interest is conducted during the review process. Disclosures will be noted in the foot-note of each article.

Accreditation/Credit Designation

The Southern Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with the ACCME Essential Areas and Elements (including the Standard for Commercial Support) and Accreditation policies. The Southern Medical Association designates this educational activity for a maximum of 2 category 1 credits toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.

Method of Participation

Participants read the entire CME feature and review illustrations, charts, bibliographies or other supplemental materials associated with the feature. A self-assessment test follows at the end of this feature that allows participants to test themselves on the knowledge obtained from the activity. Participants document their completion of this activity by submitting the CME credit form located at the end of the feature. Participants are also asked to evaluate the activity, to note specific outcomes to their practice as a result of their participation, and list other topics to be addressed in future CME features on the CME credit form.

CME Credit Instructions

Participants may request CME credit for completion of this activity by completing and submitting the CME Credit form by mail, or electronically via SMA's website at www.sma.org. A nominal fee is required to receive credit for this activity. A CME certificate will be mailed within two weeks of receipt of the CME credit form at the SMA headquarters office.

Date of Original Release: November 1, 2005

Term of Approval: 1 Year * Credit Expires: November 1, 2006

Estimated Time for Completion: 2 Hours

Credit Designation: 2 AMA PRA category 1 credits