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男性和女性伊拉克/阿富汗战争老兵的自我报告疼痛:与精神症状和功能的关联。

Self-Reported Pain in Male and Female Iraq/Afghanistan-Era Veterans: Associations with Psychiatric Symptoms and Functioning.

机构信息

Research and Development.

Mental Health Service Line.

出版信息

Pain Med. 2017 Sep 1;18(9):1658-1667. doi: 10.1093/pm/pnw308.

DOI:10.1093/pm/pnw308
PMID:28122941
Abstract

OBJECTIVE

To examine pain symptoms and co-occurring psychiatric and functional indices in male and female Iraq/Afghanistan-era veterans.

DESIGN

Self-reported data collection and interviews of Iraq/Afghanistan-era veterans who participated in a multisite study of postdeployment mental health.

SETTING

Veterans were enrolled at one of four participating VA sites.

SUBJECTS

Two thousand five hundred eighty-seven male and 662 female Iraq/Afghanistan-era veterans.

METHODS

Nonparametric Wilcoxon rank tests examined differences in pain scores between male and female veterans. Chi-square tests assessed differences between male and female veterans in the proportion of respondents endorsing moderate to high levels of pain vs no pain. Multilevel regression analyses evaluated the effect of pain on a variety of psychiatric and functional measures.

RESULTS

Compared with males, female veterans reported significantly higher mean levels of headache ( P  < 0.0001), muscle soreness ( P  < 0.008), and total pain ( P  < 0.0001), and were more likely to report the highest levels of headache ( P  < 0.0001) and muscle soreness ( P  < 0.0039). The presence of pain symptoms in Iraq/Afghanistan-era veterans was positively associated with psychiatric comorbidity and negatively associated with psychosocial functioning. There were no observed gender differences in psychiatric and functional indices when levels of pain were equated.

CONCLUSIONS

Although female Iraq/Afghanistan-era veterans reported higher levels of pain than male veterans overall, male and female veterans experienced similar levels of psychiatric and functional problems at equivalent levels of reported pain. These findings suggest that pain-associated psychological and functional impacts are comparable and consequential for both male and female veterans.

摘要

目的

研究男性和女性伊拉克/阿富汗战争时代退伍军人的疼痛症状及共病的精神和功能指标。

设计

参与一项关于部署后心理健康的多地点研究的伊拉克/阿富汗战争时代退伍军人进行自我报告数据收集和访谈。

地点

退伍军人在四个参与 VA 地点之一参加。

对象

2587 名男性和 662 名女性伊拉克/阿富汗战争时代退伍军人。

方法

非参数 Wilcoxon 秩检验用于检查男性和女性退伍军人疼痛评分之间的差异。卡方检验评估了男性和女性退伍军人中报告中度至高度疼痛与无疼痛的比例差异。多层次回归分析评估了疼痛对各种精神和功能指标的影响。

结果

与男性相比,女性退伍军人报告的头痛(P < 0.0001)、肌肉酸痛(P < 0.008)和总疼痛(P < 0.0001)的平均水平明显更高,并且更有可能报告最高水平的头痛(P < 0.0001)和肌肉酸痛(P < 0.0039)。伊拉克/阿富汗战争时代退伍军人存在疼痛症状与精神共病呈正相关,与心理社会功能呈负相关。当疼痛水平相同时,疼痛症状在伊拉克/阿富汗战争时代退伍军人的精神和功能指标中没有观察到性别差异。

结论

尽管总体而言,女性伊拉克/阿富汗战争时代退伍军人报告的疼痛水平高于男性,但在报告的疼痛水平相同时,男性和女性退伍军人经历的精神和功能问题相似。这些发现表明,与疼痛相关的心理和功能影响对男性和女性退伍军人都是可比且具有重要影响的。

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