System-based pain groups are uniquely associated with sociodemographic and psychiatric correlates among those with posttraumatic stress disorder (PTSD)

Abstract

Objective

Chronic pain is a prevalent comorbidity among those with posttraumatic stress disorder (PTSD). Chronic pain can be divided into specific pain (i.e., involving a single body system) and complex pain (i.e., involving multiple body systems). We explored sociodemographic and psychiatric differences between pain groups among those with PTSD.

Method

Data came from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, N = 36,309). Pain groups were determined through health professional confirmed self-report of chronic pain conditions within three body systems (musculoskeletal, nerve or digestive conditions). Psychiatric conditions were identified with the Alcohol Use Disorder and Associated Disabilities Interview Schedule for DSM-5; suicide attempts were assessed via self-report.

Results

Among our PTSD sub-sample (n = 1779; 4.7%), 53.9% had no conditions, 25.6% endorsed specific pain, and 19.1% endorsed complex pain. Multinomial logistic regressions revealed increased odds of certain sociodemographic correlates (e.g., older age) common to both pain groups when compared to those with PTSD alone, as well as decreased odds (e.g., being non-White) unique to those with complex pain. Multivariable logistic regressions revealed both specific pain and complex pain were associated with increased odds of any lifetime personality disorder relative to the no pain group (AOR = 1.56 and 2.38, respectively). Complex pain was uniquely associated with increased odds of any past-year anxiety disorder, past-year tobacco use disorder, and lifetime suicide attempts (AOR range = 1.46–1.69) relative to PTSD alone.

Conclusion

Findings indicate that those with PTSD and pain conditions impacting multiple body systems represent a particularly vulnerable group.