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共病慢性疼痛和创伤后应激障碍:美国退伍军人中的当前发病率和精神共病。

Comorbid Chronic Pain and Post-traumatic Stress Disorder: Current Rates and Psychiatric Comorbidities Among U.S. Military Veterans.

机构信息

VA Office of Rural Health (ORH), Veterans Rural Health Resource Center-Iowa City, Iowa City VA Health Care System, Iowa City, IA 52246, USA.

Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA 52246, USA.

出版信息

Mil Med. 2024 Nov 5;189(11-12):2303-2306. doi: 10.1093/milmed/usae313.

Abstract

INTRODUCTION

This study reports rates of comorbid chronic pain and post-traumatic stress disorder (PTSD) among U.S. military veterans and rates of psychiatric comorbidities among those with both chronic pain and PTSD.

MATERIALS AND METHODS

This study utilized National Veterans Affairs (VA) administrative data to identify all veterans treated for chronic pain or PTSD in 2023. Multivariable logistic regression models determined the likelihood of each psychiatric comorbidity for those with chronic pain and PTSD relative to those with chronic pain only and separately to those with PTSD only, after adjusting for demographic variables and all other psychiatric comorbidities.

RESULTS

Of the 5,846,453 service users of the VA in 2023, a total of 2,091,391 (35.8%) met the criteria for chronic pain and 850,191 (14.5%) met the criteria for PTSD. Furthermore, 21.6% of those with chronic pain also had PTSD and over half (53.2%) of those with PTSD also met the criteria for chronic pain (n = 452,113). Veterans with chronic pain and PTSD were significantly more likely to be women, Black or African American, Hispanic or Latina, and urban dwelling. Veterans with chronic pain and PTSD had significantly higher rates of all selected comorbidities relative to veterans with chronic pain only.

CONCLUSIONS

Patients with comorbid chronic pain and PTSD may benefit from tailored treatments to address the additive impact of these conditions.

摘要

简介

本研究报告了美国退伍军人慢性疼痛和创伤后应激障碍(PTSD)共病的发生率,以及同时患有慢性疼痛和 PTSD 的患者中精神共病的发生率。

材料与方法

本研究利用美国退伍军人事务部(VA)的行政数据,确定了 2023 年所有接受慢性疼痛或 PTSD 治疗的退伍军人。多变量逻辑回归模型确定了那些同时患有慢性疼痛和 PTSD 的患者与仅患有慢性疼痛的患者以及仅患有 PTSD 的患者相比,每种精神共病的可能性,同时调整了人口统计学变量和所有其他精神共病。

结果

在 2023 年接受 VA 治疗的 5846453 名服务使用者中,共有 2091391 人(35.8%)符合慢性疼痛标准,850191 人(14.5%)符合 PTSD 标准。此外,21.6%的慢性疼痛患者同时患有 PTSD,超过一半(53.2%)的 PTSD 患者也符合慢性疼痛标准(n=452113)。患有慢性疼痛和 PTSD 的退伍军人更有可能是女性、黑人和非裔美国人、西班牙裔或拉丁裔,以及居住在城市。患有慢性疼痛和 PTSD 的退伍军人患有所有选定的共病的比率显著高于仅患有慢性疼痛的退伍军人。

结论

患有慢性疼痛和 PTSD 共病的患者可能受益于针对这些疾病的综合治疗。

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