Chronische Schmerzen in der 11. Auflage der Internationalen Statistischen Klassifikation der Krankheiten und verwandter Gesundheitsprobleme

Approximately one in four persons in Germany is affected by chronic pain. Chronic pain is defined as pain that lasts longer than 3 months or reoccurs in the form of regular attacks during this time period. It is often associated with emotional distress or functional impairments in everyday activities. The 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11) includes a comprehensive and systematic classification of chronic pain in a dedicated chapter (MG30). This classification consists of seven main categories of chronic pain. With the assistance of subcategories at several levels chronic pain can be generally or very specifically coded, depending on the setting and requirements. Chronic primary pain (pain as a health condition in its own right) is distinguished from chronic secondary pain (pain as a symptom of an underlying health condition). Optional additional codes are available to code pain severity (consisting of the three dimensions pain intensity, emotional distress, and pain-related impairment), the presence of psychosocial factors and the pattern of the pain course over time. For the application and approval of outpatient psychotherapy, a diagnosis on a broader level is presumably sufficient. The distinction between chronic primary and chronic secondary pain is relevant for the psychotherapeutic treatment plan. Psychotherapists should be familiar with the red flags for possible chronic secondary pain in order to coordinate the necessary treatment measures with other healthcare professionals. Interdisciplinary multimodal pain treatment is the gold standard of treatment measures in Germany. The new classification can make a significant contribution to improve the access to treatment.