The Prevalence of Post-traumatic Stress Disorder in Chronic Pain Patients

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The Prevalence of Post-traumatic Stress Disorder in Chronic Pain Patients

Journal: Current Pain and Headache Reports 2004, 8:111-115

Author: J. Sharp, PhD

Affiliation: University of Sydney, Suites 101/102. 74 Pitt Street, Sydney

NSW 2000, Australia. E-Mail: mailto:timothysharp@...

Abstract:

Several of the more common causes of chronic pain include traumatic events

such as motor vehicle accidents and work-related incidents. Therefore, it

is not unusual for patients presenting with chronic pain to also describe

significant levels of distress including post-traumatic symptomatology and,

in the more severe cases, post-traumatic stress disorder (PTSD). Throughout

the past few decades, the literature relating to chronic pain and PTSD has

become progressively more sophisticated, resulting in well-supported

theories and treatments for sufferers. However, only a handful of studies

have specifically attended to the co-occurrence of these two disorders.

This review presents a summary of the literature relating to the two

disorders in terms of symptoms, prevalence, and comorbidity. It also

briefly describes the main empirically supported psychologic theories of

chronic pain and PTSD and briefly reviews the evidence regarding what

factors maintain the disorders. Treatment implications and issues for

future research are considered.

Introduction:

As highlighted in a recent review, research into the co-occurrence of

post-traumatic stress disorder (PTSD) and chronic pain is surprisingly

lacking despite the relatively high incidence of trauma in those who have

suffered severe injury and of pain in those who have experienced a

traumatic incident. It should be the cause of some concern that the

combination is only rarely referred to in the published literature given

the substantial overlap between the two disorders.

A quick review of two recent comprehensive textbooks on pain highlights

this deficit because PTSD is not even mentioned in the index or chapter

headings. Similarly, in two recent comprehensive texts on PTSD, pain is

referred to only very briefly.

In this article, both disorders are reviewed for the diagnostic criteria,

the prevalence rates, and comorbidity and current explanatory theories.

Furthermore, mutually maintaining factors are discussed briefly, with a

particular focus on clinical implications and areas for future research.

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