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患有创伤后应激障碍和重度抑郁症的阿富汗/伊拉克战争时期退伍军人的自我报告疼痛主诉。

Self-reported pain complaints among Afghanistan/Iraq era men and women veterans with comorbid posttraumatic stress disorder and major depressive disorder.

作者信息

Runnals Jennifer Jane, Van Voorhees Elizabeth, Robbins Allison T, Brancu Mira, Straits-Troster Kristy, Beckham Jean C, Calhoun Patrick S

机构信息

Mid-Atlantic Mental Illness Research Educational and Clinical Center (VISN 6 MIRECC), Durham, North Carolina; Durham Veterans Affairs Medical Center, Durham, North Carolina; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.

出版信息

Pain Med. 2013 Oct;14(10):1529-33. doi: 10.1111/pme.12208. Epub 2013 Aug 7.

Abstract

OBJECTIVE

Research has shown significant rates of comorbidity among posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and pain in prior era veterans but less is known about these disorders in Iraq and Afghanistan war era veterans. This study seeks to extend previous work by evaluating the association among PTSD, MDD, and pain (back, muscle, and headache pain) in this cohort.

METHOD

A sample of 1,614 veterans, recruited from 2005 to 2010, completed a structured clinical interview and questionnaires assessing trauma experiences, PTSD symptoms, depressive symptoms, and pain endorsement.

RESULTS

Veterans with PTSD endorsed pain-related complaints at greater rates than veterans without PTSD. The highest rate of pain complaints was observed in veterans with comorbid PTSD/MDD. Women were more likely to endorse back pain and headaches but no gender by diagnosis interactions were significant.

CONCLUSIONS

Findings highlight the complex comorbid relationship between PTSD, MDD, and pain among Iraq and Afghanistan veterans. This observed association suggests that integrated, multidisciplinary treatments may be beneficial, particularly when multiple psychological and physical health comorbidities are present with pain. Further support may be indicated for ongoing education of mental health and primary care providers about these co-occurring disorders.

摘要

目的

研究表明,在以往战争时期的退伍军人中,创伤后应激障碍(PTSD)、重度抑郁症(MDD)和疼痛的共病率很高,但对于伊拉克和阿富汗战争时期退伍军人的这些疾病了解较少。本研究旨在通过评估该队列中PTSD、MDD和疼痛(背部、肌肉和头痛疼痛)之间的关联来扩展先前的研究。

方法

从2005年至2010年招募的1614名退伍军人样本完成了结构化临床访谈以及评估创伤经历、PTSD症状、抑郁症状和疼痛认可情况的问卷。

结果

患有PTSD的退伍军人比未患PTSD的退伍军人更频繁地认可与疼痛相关的主诉。在患有PTSD/MDD共病的退伍军人中观察到最高的疼痛主诉率。女性更有可能认可背痛和头痛,但按诊断的性别交互作用均无显著意义。

结论

研究结果突出了伊拉克和阿富汗退伍军人中PTSD、MDD和疼痛之间复杂的共病关系。这种观察到的关联表明,综合的多学科治疗可能有益,特别是当多种心理和身体健康共病伴有疼痛时。可能需要进一步支持对心理健康和初级保健提供者进行关于这些共病疾病的持续教育。

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