Chronic pain and comorbid mental health conditions: independent associations of posttraumatic stress disorder and depression with pain, disability, and quality of life

Samantha D. Outcalt; Kurt Kroenke; Erin E. Krebs; Neale R. Chumbler; Jingwei Wu; Zhangsheng Yu; Matthew J. Bair

doi:10.1007/s10865-015-9628-3

Chronic pain and comorbid mental health conditions: independent associations of posttraumatic stress disorder and depression with pain, disability, and quality of life

Samantha D. Outcalt, Kurt Kroenke, Erin E. Krebs, Neale R. Chumbler, Jingwei Wu, Zhangsheng Yu, Matthew J. Bair

Medicine - Veteran's Administration Medical Center

Research output: Contribution to journal › Article › peer-review

136 Scopus citations

Abstract

Both posttraumatic stress disorder (PTSD) and depression are highly comorbid with chronic pain and have deleterious effects on pain and treatment outcomes, but the nature of the relationships among chronic pain, PTSD, and depression has not been fully elucidated. This study examined 250 Veterans Affairs primary care patients with moderate to severe chronic musculoskeletal pain who participated in a randomized controlled pain treatment trial. Baseline data were analyzed to examine the independent associations of PTSD and major depression with multiple domains of pain, psychological status, quality of life, and disability. PTSD was strongly associated with these variables and in multivariate models, PTSD and major depression each had strong independent associations with these domains. PTSD demonstrated similar relationships as major depression with psychological, quality of life, and disability outcomes and significant but somewhat smaller associations with pain. Because PTSD and major depression have independent negative associations with pain, psychological status, quality of life, and disability, it is important for clinicians to recognize and treat both mental disorders in patients with chronic pain.

Original language	English (US)
Pages (from-to)	535-543
Number of pages	9
Journal	Journal of Behavioral Medicine
Volume	38
Issue number	3
DOIs	https://doi.org/10.1007/s10865-015-9628-3
State	Published - Jun 1 2015

Bibliographical note

Funding Information:
This work was supported by a Department of Veterans Affairs Health Services Research and Development (VA HSR&D) Merit Review award to Dr. Kroenke (IIR 07-119) and Career Development Award to Dr. Krebs (CDA 07-215). The sponsor had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

Publisher Copyright:
© 2015, Springer Science+Business Media New York (outside the USA).

Keywords

Chronic pain
Depression
Disability
PTSD
Quality of life
Veterans

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10.1007/s10865-015-9628-3

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Chronic pain and comorbid mental health conditions: independent associations of posttraumatic stress disorder and depression with pain, disability, and quality of life. / Outcalt, Samantha D.; Kroenke, Kurt; Krebs, Erin E. et al.
In: Journal of Behavioral Medicine, Vol. 38, No. 3, 01.06.2015, p. 535-543.

Research output: Contribution to journal › Article › peer-review

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abstract = "Both posttraumatic stress disorder (PTSD) and depression are highly comorbid with chronic pain and have deleterious effects on pain and treatment outcomes, but the nature of the relationships among chronic pain, PTSD, and depression has not been fully elucidated. This study examined 250 Veterans Affairs primary care patients with moderate to severe chronic musculoskeletal pain who participated in a randomized controlled pain treatment trial. Baseline data were analyzed to examine the independent associations of PTSD and major depression with multiple domains of pain, psychological status, quality of life, and disability. PTSD was strongly associated with these variables and in multivariate models, PTSD and major depression each had strong independent associations with these domains. PTSD demonstrated similar relationships as major depression with psychological, quality of life, and disability outcomes and significant but somewhat smaller associations with pain. Because PTSD and major depression have independent negative associations with pain, psychological status, quality of life, and disability, it is important for clinicians to recognize and treat both mental disorders in patients with chronic pain.",

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Chronic pain and comorbid mental health conditions: independent associations of posttraumatic stress disorder and depression with pain, disability, and quality of life

Abstract

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