Physical health correlates of co-occurring chronic pain and PTSD Among U.S. Veterans: Results from a nationally representative study

Abstract

Co-occurring chronic pain and posttraumatic stress disorder (PTSD) affects between 4%-8% of the U.S. veteran population. A large body of research has documented the psychosocial burden of the co-occurrence, but fewer studies have examined physical health conditions and functioning. The current study aimed to address this gap by examining physical health conditions and functioning of co-occurring chronic pain and PTSD. Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 4,069 (age=62.2 years) U.S. veterans in 2019–2020. The sample was predominantly male (N = 3,564; 90.2%) and non-Hispanic White (N = 3,318; 78.0%). PTSD diagnoses were determined using the PTSD Checklist for DSM-5 and chronic pain and other physical health conditions using self-report and validated measures. Logistic regression analyses revealed that veterans with co-occurring chronic pain and PTSD were generally more likely to have a physical health condition (ORs 2.79–9.53) or a cognitive disorder (OR=16.55) relative to controls (ORs 2.79–9.53). ANCOVA analyses revealed that relative to veterans with chronic pain or PTSD only, those with both chronic pain and PTSD had worse physical functioning across several domains (ds=0.32–1.13). Results underscore the importance of approaching co-occurring chronic pain and PTSD using a whole person approach to care that targets both physical and mental health concerns.