Post-traumatic stress disorder among patients with chronic pain and chronic fatigue

2004 ◽  
Vol 34 (2) ◽  
pp. 363-368 ◽  
Author(s):  
P. ROY-BYRNE ◽  
W. R. SMITH ◽  
J. GOLDBERG ◽  
N. AFARI ◽  
D. BUCHWALD

Background. Fibromyalgia (FM), a chronic pain condition of unknown aetiology often develops following a traumatic event. FM has been associated with post-traumatic stress disorder (PTSD) and major depression disorder (MDD).Method. Patients seen in a referral clinic (N=571) were evaluated for FM and chronic fatigue syndrome (CFS) criteria. Patients completed questionnaires, and underwent a physical examination and a structured psychiatric evaluation. Critical components of the diagnostic criteria of FM (tender points and diffuse pain) and CFS (persistent debilitating fatigue and four of eight associated symptoms) were examined for their relationship with PTSD.Results. The prevalence of lifetime PTSD was 20% and lifetime MDD was 42%. Patients who had both tender points and diffuse pain had a higher prevalence of PTSD (OR=3·4, 95% CI 2·0–5·8) compared with those who had neither of these FM criteria. Stratification by MDD and adjustment for sociodemographic factors and chronic fatigue revealed that the association of PTSD with FM criteria was confined to those with MDD. Patients with MDD who met both components of the FM criteria had a three-fold increase in the prevalence of PTSD (95% CI 1·5–7·1); conversely, FM patients without MDD showed no increase in PTSD (OR=1·3, 95% CI 0·5–3·2). The components of the CFS criteria were not significantly associated with PTSD.Conclusion. Optimal clinical care for patients with FM should include an assessment of trauma in general, and PTSD in particular. This study highlights the importance of considering co-morbid MDD as an effect modifier in analyses that explore PTSD in patients with FM.

AIDS Care ◽  
2021 ◽  
pp. 1-8
Author(s):  
Elenore Bhatraju ◽  
Jane M. Liebschutz ◽  
Sara Lodi ◽  
Leah S. Forman ◽  
Marlene C. Lira ◽  
...  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Quinn M. Biggs ◽  
Robert J. Ursano ◽  
Jing Wang ◽  
Gary H. Wynn ◽  
Rohul Amin ◽  
...  

Abstract Background Sleep disturbances are common in individuals with post traumatic stress disorder (PTSD). However, little is known about how daily variation in sleep characteristics is related to PTSD. This study examined the night-to-night and weekday versus weekend variation in sleep duration, sleep quality, trouble falling asleep, and difficulty staying asleep in individuals with and without PTSD. Methods Participants (N = 157; 80 with PTSD, 77 without PTSD) completed daily self-reports of their nighttime sleep characteristics for 15 consecutive days. Linear mixed models were used to examine the associations between the 7 days of the week and weekday versus weekend variation in sleep characteristics and PTSD. Results Individuals with PTSD reported shorter sleep duration, lower sleep quality, more trouble falling asleep, and more difficulty staying asleep than individuals without PTSD. The pattern of change across the week and between weekdays and weekends was different between those with and without PTSD for sleep quality and trouble falling asleep. Among those with PTSD, sleep duration, sleep quality, and trouble falling asleep differed across the 7 days of the week and showed differences between weekdays and weekends. For those without PTSD, only sleep duration differed across the 7 days of the week and showed differences between weekdays and weekends. Neither group showed 7 days of the week nor weekday versus weekend differences in difficulty staying asleep. Conclusions On average those with PTSD had shorter sleep duration, poorer sleep quality, and greater trouble falling and staying asleep. In particular, the day of week variation in sleep quality and trouble falling asleep specifically distinguishes those with PTSD from those without PTSD. Our findings suggest that clinical care might be improved by assessments of sleep patterns and disturbances across at least a week, including weekdays and weekends. Future studies should explore the mechanisms related to the patterns of sleep disturbance among those with PTSD.


Author(s):  
Jordana L. Sommer ◽  
Rachel Roy ◽  
Pamela L. Holens ◽  
Renée El-Gabalawy

This chapter summarizes the current literature on post-traumatic stress disorder (PTSD) and chronic pain among military personnel in Canada, the United States, and the United Kingdom, including an overview of clinical features, prevalence, correlates, comorbidity, assessment, and intervention. PTSD and chronic pain are both prevalent among military populations and commonly co-occur; however, prevalence estimates tend to vary in the literature, according to type of assessment, timing of assessment, and subsample of interest. Both PTSD and chronic pain are independently associated with various adverse correlates such as psychiatric and physical health comorbidity, and research suggests there are poorer health and adverse psychosocial effects when these conditions co-occur. These findings highlight the importance of adequate prevention, screening, and interventions among this population.


2019 ◽  
Vol 14 (4) ◽  
pp. 256-262
Author(s):  
Louise Morgan ◽  
Dominic Aldington

Introduction: Chronic pain and post-traumatic stress disorder (PTSD) are strongly correlated in military veteran populations. The aim of this article is to review what is known about the comorbidity of the two conditions. Methods: A literature search was carried out to establish evidence for current explanatory models of why the two conditions frequently co-occur, the most appropriate treatments and current UK service provision for veterans and to identify gaps in research. Results: Chronic pain and PTSD share a number of features, yet the mechanisms behind their comorbidity are not well understood, and while each condition alone has extensive literature, there is limited evidence to support specific care and treatment for the two conditions simultaneously. In addition, there is currently no UK data for veterans with comorbid chronic pain and PTSD so it is not possible to gauge the numbers affected or to predict the numbers who will be affected in the future, and there appear to be no co-located services within the United Kingdom for the management of the two conditions simultaneously in this population. Conclusion: This review highlights a paucity of evidence in all areas of comorbid chronic pain and PTSD. Further work needs to consider fully the nature of the event that led to the development of the two conditions and examine further the possible mechanisms involved, and clinics need to establish routine and systematic evaluations of how any interventions work in practice.


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