From the Institute for Neuroradiology (Manuel), Hannover Medical School, Hannover; Institute of Aerospace Medicine (Manuel), German Aerospace Center (DLR), Cologne; Department of Cardiothoracic, Transplantation, and Vascular Surgery (Rudolph), Hannover Medical School; Insula Institute for Integrative Therapy Research (Beissner); Department of Anesthesiology, Intensive Care, Emergency and Pain Management (Neubert), DIAKOVERE Friederikenstift; and Department of Anesthesiology and Intensive Care Medicine, Pain Clinic (Dusch, Karst), Hannover Medical School, Hannover, Germany.
Psychosom Med. 2023 May 1;85(4):351-357. doi: 10.1097/PSY.0000000000001181. Epub 2023 Feb 21.
Posttraumatic stress disorder (PTSD) and traumatic life events are often coupled to chronic pain, possibly linked by central sensitization. We wanted to assess the prevalence of traumatic events and PTSD in chronic pain patients of a German university hospital outpatient pain clinic. Moreover, we evaluated the extent of indicators and co-occurring traits of central sensitization in comorbid patients.
We retrospectively divided 914 chronic pain patients into four groups depending on their trauma severity: no trauma, accidental trauma, interpersonal trauma, and PTSD. We collected electronic pain drawings focusing on pain area and widespreadness, as well as information about pain intensity, sleep impairment, disability, stress, anxiety, depression, and somatization. Differences between groups were calculated using Kruskal-Wallis with post-hoc Mann-Whitney tests.
Of 914 patients, 231 (25%) had no trauma, 210 (23%) had accidental traumas, 283 (31%) had interpersonal traumas, 99 (11%) had PTSD, and 91 (10%) could not be classified. We observed statistically significant differences between groups in pain area and widespreadness, as well as maximal pain, sleep impairment, disability, stress, anxiety, depression, and somatization. The severity of symptoms increased with trauma severity.
Traumatic life events and PTSD are frequent in chronic pain patients. The increased pain area and widespreadness, as well as the increased negative impact on co-occurring traits of sensory sensitivity (anxiety, depression, somatization), are compatible with central sensitization in comorbid patients. Therefore, a heightened awareness of the comorbidity between traumatic experiences and chronic pain is recommended.
创伤后应激障碍（PTSD）和创伤性生活事件常与慢性疼痛同时发生，其可能与中枢敏化有关。我们旨在评估德国一所大学附属医院门诊疼痛诊所慢性疼痛患者中创伤事件和 PTSD 的发生率。此外，我们还评估了合并患者中枢敏化相关指标和共病特征的严重程度。
我们根据创伤严重程度将 914 名慢性疼痛患者分为 4 组：无创伤、意外创伤、人际创伤和 PTSD。我们收集了电子疼痛图，重点关注疼痛区域和广泛性，以及疼痛强度、睡眠障碍、残疾、压力、焦虑、抑郁和躯体化等信息。使用 Kruskal-Wallis 检验和事后 Mann-Whitney 检验比较组间差异。
914 名患者中，231 名（25%）无创伤，210 名（23%）有意外创伤，283 名（31%）有人际创伤，99 名（11%）有 PTSD，91 名（10%）无法分类。我们观察到组间在疼痛区域和广泛性，以及最大疼痛、睡眠障碍、残疾、压力、焦虑、抑郁和躯体化等方面存在统计学显著差异。症状严重程度随创伤严重程度而增加。
创伤性生活事件和 PTSD 在慢性疼痛患者中较为常见。疼痛区域和广泛性增加，以及对共存感觉敏感性（焦虑、抑郁、躯体化）的负面影响增加，与合并患者的中枢敏化一致。因此，建议提高对创伤经历与慢性疼痛共病的认识。
