Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain.

Abstract:

:Background: Trauma exposure and post-traumatic stress disorder (PTSD) are risk factors for chronic pain. Objective: This study investigated how exposure to intentional and non-intentional traumatic events and PTSD are related to pain severity and outcome of treatment in chronic pain patients. Methods: We assessed exposure to potentially traumatizing events, psychiatric diagnosis with structured clinical interview, and pain severity in 63 patients at a secondary multidisciplinary pain clinic at the beginning of treatment, and assessed level of pain at follow up. Exposure to potentially traumatizing events and PTSD were regressed on pain severity at the initial session and at follow up in a set of multiple regression analysis. Results: The participants reported exposure to an average of four potentially traumatizing events, and 32% had PTSD. Exposure to intentional traumatic events and PTSD were significantly associated with more severe pain, and PTSD significantly moderated the relationship between trauma exposure and pain (all p < .05). The treatment programme reduced pain moderately, an effect that was unrelated to trauma exposure and PTSD. Conclusions: Trauma exposure is related to chronic pain in the same pattern as to mental disorders, with intentional trauma being most strongly related to pain severity. PTSD moderated the relationship between trauma exposure and pain. While pain patients with PTSD initially report more pain, they responded equally to specialist pain treatment as persons without PTSD. :Planteamiento: La exposición al trauma y el trastorno de estrés postraumático (TEPT) son factores de riesgo para el dolor crónico. Este estudio investigó cómo el TEPT y la exposición a acontecimientos traumáticos intencionales y no intencionales se relacionan con la gravedad del dolor y el resultado del tratamiento en pacientes con dolor crónico. Métodos: Al inicio del tratamiento, evaluamos la exposición a acontecimientos potencialmente traumatizantes, el diagnóstico psiquiátrico con la entrevista clínica estructurada y la gravedad del dolor en 63 pacientes de una clínica para el dolor multidisciplinaria secundaria. En el seguimiento, se evaluó el nivel de dolor. La exposición a acontecimientos potencialmente traumatizantes y al TEPT había retrocedido en cuanto a la gravedad del dolor en la sesión inicial y en el seguimiento en un conjunto de análisis de regresión múltiple. Resultados: Los participantes informaron de la exposición a un promedio de cuatro eventos potencialmente traumatizantes, y el 32% tenían TEPT. La exposición a eventos traumáticos intencionales y el TEPT se asociaron significativamente con dolor más intenso y el TEPT moderó significativamente la relación entre la exposición al trauma y el dolor (todos los valores p <0,05). El programa de tratamiento redujo el dolor moderadamente, efecto que no estaba relacionado con la exposición al trauma y el TEPT. Conclusiones: La exposición al trauma está relacionada con el dolor crónico de modo similar que con los trastornos mentales, siendo el trauma intencional el que está más intensamente relacionado con la gravedad del dolor. El TEPT moderó la relación entre la exposición al trauma y el dolor. Mientras que los pacientes con dolor y con TEPT inicialmente refirieron más dolor, respondieron del mismo modo al tratamiento especializado del dolor como las personas sin TEPT. :背景:创伤暴露和创伤后应激障碍(PTSD)是长期疼痛的风险因素。这个研究考察暴露于人为和非人为的创伤事件和PTSD是如何和长期疼痛患者的疼痛严重程度、治疗结果相关联的。 方法:在二级综合疼痛诊所中招募63名病人,在治疗的开始阶段我们评估了可能的创伤事件和疼痛程度,并使用结构化访谈进行精神诊断;在追踪阶段再次评估了疼痛程度。可能创伤事件的暴露和PTSD在初始和追踪疼痛程度上进行了一组多元回归。 结果:被试平均暴露于四个可能创伤事件,其中32%患有PTSD。暴露人为创伤事件和PTSD和更严重的疼痛显著相关;PTSD显著调节创伤暴露和疼痛的关系(所有p < .05)。治疗过程稍微减少了疼痛,但和创伤暴露和PTSD没有关系。 结论:创伤暴露和长期疼痛的关系模式就像和精神疾病一样,人为创伤和疼痛程度的关联最强。PTSD调节了创伤暴露和疼痛的关系。患有PTSD的疼痛病人最初报告更多疼痛,但他们和其它没有PTSD的病人对专门疼痛治疗的反应没有差别。.

journal_name

Eur J Psychotraumatol

authors

Siqveland J,Ruud T,Hauff E

doi

10.1080/20008198.2017.1375337

subject

Has Abstract

pub_date

2017-09-19 00:00:00

pages

1375337

issue

1

issn

2000-8066

pii

1375337

journal_volume

8

pub_type

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