Post-traumatic stress disorder and risky opioid use among persons living with HIV and chronic pain

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


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.


BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e032435 ◽  
Author(s):  
Chulei Tang ◽  
Lloyd Goldsamt ◽  
Jingjing Meng ◽  
Xueling Xiao ◽  
Li Zhang ◽  
...  

ObjectivesAlthough people living with HIV (PLWH) have been disproportionately affected by post-traumatic stress disorder (PTSD), the global prevalence of PTSD among PLWH is unknown. This study aimed to systematically review the prevalence of PTSD among PLWH worldwide and explore variation in prevalence across sociodemographic and methodological factors.DesignA meta-analysis using a random-effects model was conducted to pool the prevalence estimated from individual studies, and subgroup analyses were used to analyse heterogeneities.Setting, participants and measuresObservational studies providing PTSD prevalence data in an adult HIV population were searched from January 2000 to November 2019. Measurements were not restricted, although the definition of PTSD had to align with the Diagnostic and Statistical Manual of Mental Disorders or the International Classification of Diseases diagnostic criteria.ResultsA total of 38 articles were included among 2406 records identified initially. The estimated global prevalence of PTSD in PLWH was 28% (95% CI 24% to 33%). Significant heterogeneity was detected in the proportion of PLWH who reported PTSD across studies, which was partially explained by geographic area, population group, measurement and sampling method (p<0.05).ConclusionPTSD among PLWH is common worldwide. This review highlights that PTSD should be routinely screened for and that more effective prevention strategies and treatment packages targeting PTSD are needed in PLWH.


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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