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创伤后应激障碍严重程度和疼痛结局的性别差异:LAMP 试验的基线结果。

Gender differences in PTSD severity and pain outcomes: Baseline results from the LAMP trial.

机构信息

VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Health Care System (VAGLACS), Los Angeles, California, United States of America.

Center for Care Delivery and Outcomes Research, Minneapolis Veterans Affairs Healthcare System (MVAHCS), Minneapolis, Minnesota, United States of America.

出版信息

PLoS One. 2024 May 16;19(5):e0293437. doi: 10.1371/journal.pone.0293437. eCollection 2024.

Abstract

BACKGROUND

Post-traumatic stress disorder (PTSD) and chronic pain are highly prevalent comorbid conditions. Veterans dually burdened by PTSD and chronic pain experience more severe outcomes compared to either disorder alone. Few studies have enrolled enough women Veterans to test gender differences in pain outcomes [catastrophizing, intensity, interference] by the severity of PTSD symptoms.

AIM

Examine gender differences in the association between PTSD symptoms and pain outcomes among Veterans enrolled in a chronic pain clinical trial.

METHODS

Participants were 421 men and 386 women Veterans with chronic pain who provided complete data on PTSD symptoms and pain outcomes. We used hierarchical linear regression models to examine gender differences in pain outcomes by PTSD symptoms.

RESULTS

Adjusted multivariable models indicated that PTSD symptoms were associated with higher levels of pain catastrophizing (0.57, 95% CI [0.51, 0.63]), pain intensity (0.30, 95% CI [0.24, 0.37]), and pain interference (0.46, 95% CI [0.39, 0.52]). No evidence suggesting gender differences in this association were found in either the crude or adjusted models (all interaction p-values<0.05).

CONCLUSION

These findings may reflect the underlying mutual maintenance of these conditions whereby the sensation of pain could trigger PTSD symptoms, particularly if the trauma and pain are associated with the same event. Clinical implications and opportunities testing relevant treatments that may benefit both chronic pain and PTSD are discussed.

摘要

背景

创伤后应激障碍(PTSD)和慢性疼痛是高度普遍的共病。与仅患有 PTSD 或慢性疼痛相比,同时患有 PTSD 和慢性疼痛的退伍军人经历更严重的后果。很少有研究招募了足够多的女性退伍军人来测试 PTSD 症状严重程度对疼痛结果[灾难化、强度、干扰]的性别差异。

目的

检查 PTSD 症状与参加慢性疼痛临床试验的退伍军人的疼痛结果之间的关联中的性别差异。

方法

参与者为 421 名男性和 386 名患有慢性疼痛的女性退伍军人,他们提供了 PTSD 症状和疼痛结果的完整数据。我们使用分层线性回归模型来检查 PTSD 症状与疼痛结果之间的性别差异。

结果

调整后的多变量模型表明,PTSD 症状与更高水平的疼痛灾难化(0.57,95%置信区间[0.51,0.63])、疼痛强度(0.30,95%置信区间[0.24,0.37])和疼痛干扰(0.46,95%置信区间[0.39,0.52])相关。在未调整和调整模型中,均未发现这种关联存在性别差异的证据(所有交互 p 值均<0.05)。

结论

这些发现可能反映了这些情况的潜在相互维持,即疼痛的感觉可能引发 PTSD 症状,特别是如果创伤和疼痛与同一事件相关。讨论了临床意义和机会测试可能对慢性疼痛和 PTSD 都有益的相关治疗方法。

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