Study Suggests OEF/OIF Veterans with PTSD Experience More Pain Complaints than Veterans without PTSD
BACKGROUND:
PTSD and chronic pain may maintain or exacerbate symptoms of the other condition. Clinical samples of Vietnam-era Veterans suggest rates of 66% to 80% for comorbid PTSD and pain. Although evidence suggests pain complaints are common among OEF/OIF Veterans, less is known about PTSD and pain in this cohort. This study sought to extend previous work by evaluating the association among PTSD, major depressive disorder (MDD), and pain among Iraq and Afghanistan war era Veterans (n=1,614). Using data from clinical interviews and surveys conducted between 2005 and 2010, investigators assessed trauma exposure, psychiatric diagnosis, and pain-related health complaints (back, muscle, and headache). Veterans were categorized into four groups according to psychiatric diagnoses: 1) current PTSD (n=283), 2) current MDD (n=71), 3) current comorbid PTSD/MDD (n=239), and 4) no current PTSD or MDD (n=1,021). Investigators also examined results in regard to age, race, and war-zone exposure.
FINDINGS:
- Veterans with PTSD reported pain-related complaints at greater rates than Veterans without PTSD. PTSD - with or without MDD - was associated with increased risk of back, muscle, or headache pain. The highest rate of pain complaints was found in Veterans with comorbid PTSD and MDD.
- Women Veterans were more likely to report back pain, muscle aches, and headaches, but the relationship between psychiatric diagnsoses and pain did not differ in men and women.
- Veterans with PTSD - with or without MDD - were more likely to have war-zone service than Veterans with MDD alone or no PTSD/MDD. Veterans with PTSD/MDD were less likely to be employed, more likely to be receiving disability compensation, and more likely to report combat-related injury than Veterans without either disorder.
LIMITATIONS:
- Pain measurement was based on self-report, and prior physical injury was not assessed.
IMPLICATIONS:
- Observed associations of PTSD and MDD with pain complaints suggest that integrated, multidisciplinary treatment may be beneficial, particularly for Veterans with multiple mental health comorbities and pain.
AUTHOR/FUNDING INFORMATION:
Drs. Beckham and Calhoun are part of HSR&D's Center for Health Services Research in Primary Care, Durham, NC. All authors, except Dr. Straits-Troster, are part of VA's Mid-Atlantic Mental Illness Research Educational and Clinical Center (VISN 6 MIRECC) and the Durham VA Medical Center.
Runnals J, Van Voorhees E, Robbins A, Brancu M, Straits-Troster K, Beckham J, and Calhoun P. Self-Reported Pain Complaints among Afghanistan/Iraq Era Men and Women Veterans with Comorbid Post-traumatic Stress Disorder and Major Depressive Disorder. Pain Medicine August 7 2013;E-pub ahead of print.
