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Multiple Pain Conditions: Overlap, Gender Differences, and Associations with Post-Traumatic Stress Disorder Among Veterans
Abstract   Peer reviewed

Multiple Pain Conditions: Overlap, Gender Differences, and Associations with Post-Traumatic Stress Disorder Among Veterans

Katherine Hadlandsmyth, Mary A. Driscoll, Nicole L. Johnson, Jasmine G. Mares, Michelle A. Mengeling, Emily B.K. Thomas, Sonya B. Norman and Brian C. Lund
The journal of pain, Vol.25(4 Supplement), pp.44-45
04/2024
DOI: 10.1016/j.jpain.2024.01.207

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Abstract

Women are more likely to experience multiple overlapping pain conditions (MOPCs) relative to men and posttraumatic stress disorder can negatively impact the severity and trajectory of chronic pain and its treatment. Specific associations between gender, PTSD, and MOPCs require further examination. A cohort of all Veterans who met criteria for one or more of 12 chronic pain types during 2021 was created using national Veterans Health Administration administrative data. MOPCs were defined as the number of pain types for which each patient met criteria. Multivariable logistic regression models were used to estimate gender differences in frequency for each of the 12 pain subtypes, after controlling for demographics and comorbidities. Negative binomial regression was used to estimate gender differences in the count of MOPCs and explore moderation effects between gender and PTSD. The cohort included 1,936,859 Veterans with chronic pain in 2021, including 12.5% women. Women Veterans had higher rates of MOPCs (Mean=2.3) relative to men (Mean=1.9): aIRR = 1.31, 95% CI: 1.30-1.32. PTSD also served as an independent risk factor for MOPCs in adjusted analysis (aIRR = 1.23, 95% CI: 1.23-1.24). The interaction term between gender and PTSD was not significant (p = 0.87). Depressive disorders also served as a strong risk factor for MOPCs, independent of PTSD (aIRR = 1.37, 95% CI: 1.36 – 1.37). Individuals with MOPCs and PTSD may have more complex treatment needs and may benefit from highly coordinated trauma-sensitive care as well as integrated interventions that simultaneously address pain and PTSD. Funding: VA ORH: 03857.

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