患有创伤后应激障碍的美国退伍军人的多部位疼痛：患病率、预测因素以及与症状群的关联

IF 4 2区医学 Q1 CLINICAL NEUROLOGY

Journal of Pain Pub Date : 2024-12-27 DOI:10.1016/j.jpain.2024.104763

Joel N. Fishbein , Anne Malaktaris , Niloofar Afari , Matthew S. Herbert

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引用次数: 0

摘要

在多个不同的身体部位持续疼痛与较差的功能结果相关，超出疼痛强度和干扰。退伍军人，尤其是那些患有创伤后应激障碍（PTSD）的人，可能有多处疼痛的风险。然而，迄今为止关于这种表现的研究是有限的。这一次要分析检查了退伍军人多部位疼痛的流行程度，并探讨了具有临床显著PTSD症状的退伍军人中与多部位疼痛相关的人口统计学、兵役相关和PTSD症状聚类变量。参与者为4303名9/11后美国退伍军人（女性16.55%，白人/高加索58.45%，法师= 35.52），其中1375名（31.95%）有临床显著的PTSD症状。多部位疼痛被定义为在患者医疗保健问卷-15的5个身体部位中有3个以上“困扰[我]很多”的疼痛。总共有20.03%的参与者和40.00%的可能患有创伤后应激障碍的参与者报告了多部位疼痛。女性（OR = 1.55）、年龄较大（OR = 1.70）、少数民族种族认同（白人/高加索种族认同OR = 0.75）、军事性创伤史（OR = 1.99）、脊柱、腹部和关节/肌肉损伤（OR = 1.66-3.68）与多发部位疼痛相关。对这些潜在的混杂因素进行调整后，PTSD唤醒/反应性的z-得分较高(OR = 1.58, p

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Multisite pain among United States Veterans with posttraumatic stress disorder: Prevalence, predictors, and associations with symptom clusters

Persistent pain in multiple distinct body sites is associated with poorer functional outcomes above and beyond pain intensity and interference. Veterans, and especially those with posttraumatic stress disorder (PTSD), may be at risk for multisite pain. However, the research to date characterizing this presentation is limited. This secondary analysis examined the prevalence of multisite pain in a cross-sectional sample of Veterans and explored demographic, military service-related, and PTSD symptom cluster variables associated with multisite pain among those with clinically significant PTSD symptoms. Participants were 4303 post-9/11 U.S. Veterans (16.55% female gender, 58.45% White/Caucasian, M_age = 35.52), of whom 1375 (31.95%) had clinically significant PTSD symptoms. Multisite pain was defined as endorsing pain that “bothered [me] a lot” in ≥3 body sites out of 5 on the Patient Healthcare Questionnaire-15. A total of 20.03% of all participants, and 40.00% of those with likely PTSD, reported multisite pain. Female gender (OR = 1.55), older age (OR = 1.70), minority race identification (White/Caucasian racial identity OR = 0.75), history of military sexual trauma (OR = 1.99), and spine, abdomen and joint/muscle injuries (ORs = 1.66–3.68) were associated with higher odds of multisite pain. Adjusting for these potential confounders, higher z-scores on the PTSD arousal/reactivity (OR = 1.58, p <.001) subscale was associated with higher multisite pain odds. In summary, multisite pain was common among Veterans with PTSD, especially those who experienced military sexual trauma or certain physical injuries. Multisite pain and PTSD may be associated due to a shared threat reactivity mechanism.

Perspective

This study investigates the rates and factors associated with having pain in three or more distinct body sites (multisite pain) among United States Veterans. The study findings highlight the unique importance of specific posttraumatic stress symptoms and experiences associated with multisite pain.

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来源期刊

Journal of Pain 医学-临床神经学

CiteScore

6.30

自引率

7.50%

发文量

441

审稿时长

42 days

期刊介绍： The Journal of Pain publishes original articles related to all aspects of pain, including clinical and basic research, patient care, education, and health policy. Articles selected for publication in the Journal are most commonly reports of original clinical research or reports of original basic research. In addition, invited critical reviews, including meta analyses of drugs for pain management, invited commentaries on reviews, and exceptional case studies are published in the Journal. The mission of the Journal is to improve the care of patients in pain by providing a forum for clinical researchers, basic scientists, clinicians, and other health professionals to publish original research.