AB232. Chronic pain and shame: a narrative systematic review

Background: Chronic pain is currently one of the most difficult and trying disease processes to understand1, knowledge of how it affects the patient as a whole can be even more problematic for clinicians. Shame related to chronic disease process has shown to carry higher burden and morbidity on the patient, although poorly understood at this point2. The objective of this systematic review was assess the literature regarding shame and chronic pain.

Methods: Search terms of “chronic pain”, “shame”, “suffering”, “morbidity and mortality” and “guilt” were entered into search engines of OpenAthens, PubMed and GoogleScholar. Articles were selected based on recent publication, post 2012, and relevance to search definitions.

Results: Of the three studies found, all three reported a link with chronic pain and related psychological disability such as shame. One study showed correlation with shame and further relation to physical manifestations of pain. All three studies recommended multidisciplinary approach to treating chronic pain as there is high incidence of reported psychological complications with chronic pain

Conclusions: From this systematic review we can see that chronic pain and shame are linked. Shame associated with chronic pain has being shown to have a higher incidence of psychological morbidity and should be addressed with a multidisciplinary approach. Further research is needed to fully understand how shame and chronic pain affect one another.

Keywords: Chronic pain; shame; chronic pain co-morbidities; burden of chronic pain; guilt; humiliation; psycho-social aspects of chronic pain