Chronic Pain Types Differ in Their Reported Prevalence of Post -Traumatic Stress Disorder (PTSD) and There Is Consistent Evidence That Chronic Pain Is Associated with PTSD: An Evidence-Based Structured Systematic Review

Fishbain, David A.; Pulikal, Aditya; Lewis, John E.; Gao, Jinrun

doi:10.1093/pm/pnw065

Cited by 130 publications

(133 citation statements)

References 148 publications

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“…28 Consistent with other research, we found an association between a personal history of victimization,, 22 arthritis, and PTSD symptoms with chronic pain. 2, 27 In contrast to other populations, 7, 18, 37, 39 we did not find an association between either substance use, number of chronic medical conditions, nor depression and chronic pain.…”

Section: Discussioncontrasting

confidence: 99%

Characteristics and Factors Associated With Pain in Older Homeless Individuals: Results From the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) Study

Landefeld

Miaskowski

Tieu

et al. 2017

The Journal of Pain

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Individuals experiencing homelessness in the United States are aging; little is known about chronic pain in this population. In a cross-sectional, population-based study, we interviewed 350 homeless individuals aged 50 and older to describe pain experienced by older persons experiencing homelessness and to assess factors associated with chronic moderate to severe pain, defined as pain lasting ≥3 months, with a past week average severity score of 5–10 (scale 0–10). The median age of participants was 58 years. Participants were predominantly African American (79.6%) and male (77.3%). Overall, 46.8% reported chronic moderate to severe pain. Almost half of participants reported a diagnosis of arthritis (44.3%) and one-third reported symptoms consistent with post-traumatic stress disorder (PTSD, 32.8%). Three-quarters (75.3%) endorsed a personal history of abuse. In multivariate analyses, PTSD (AOR: 2.2, CI 1.4–3.7), arthritis (AOR: 4.8, CI 3.0–7.8), and history of experiencing abuse (AOR: 2.4, CI 1.3–4.3) were associated with chronic moderate to severe pain. HIV status, diabetes, depressive symptoms, and substance use were not associated with pain. Clinicians should consider the management of associated mental health conditions and the sequelae of experiencing abuse in the treatment of chronic pain in older adults experiencing homelessness.

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Section: Discussioncontrasting

confidence: 99%

Characteristics and Factors Associated With Pain in Older Homeless Individuals: Results From the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) Study

Landefeld

Miaskowski

Tieu

et al. 2017

The Journal of Pain

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“…Therefore, the included studies indicated a higher PTSD prevalence in TMD subjects than in the general population. These results corroborate a recently published systematic review demonstrating that there is sufficient evidence to confirm the association between PTSD and chronic painful conditions 29 . In addition, PTSD seems to be strongly associated with certain conditions of chronic pain in the craniofacial segment than other conditions.…”

Section: Discussionsupporting

confidence: 91%

“…In addition, PTSD seems to be strongly associated with certain conditions of chronic pain in the craniofacial segment than other conditions. In a subgroup analysis, the PTSD prevalence was higher among subjects with a headache and facial pain (9 to 25%) than in subjects with lumbar pain (0.3 to 0.7%) 29,30 . TMD patients reported traumatic stressors of different natures.…”

Section: Discussionmentioning

confidence: 82%

Post-traumatic stress disorder and temporomandibular dysfunction: a review and clinical implications

Ferreira¹,

Vaz²,

Stuginski‐Barbosa³

et al. 2018

Brazilian Journal of Pain

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BACKGROUND AND OBJECTIVES: Post-traumatic stress disorder is a disabling disorder that can be developed after a person has experienced or exposed to a traumatic event. The evidence shows the coexistence between post-traumatic stress disorder and chronic painful conditions as the temporomandibular dysfunction. This study aimed to review the literature to describe the coexistence relation between post-traumatic stress disorder and temporomandibular dysfunction. CONTENTS: A non-systematic search was carried on the Pubmed, BVS and LILACS databases on studies evaluating the relationship between post-traumatic stress disorder and temporomandibular dysfunction. Clinical studies published in the last 10 years that presented a diagnostic criterion validated for temporomandibular dysfunction and the post-traumatic stress disorder were selected. Six studies were included in the review. The results showed that the post-traumatic stress disorder often occurs in patients with temporomandibular dysfunction and, at the same time, a higher prevalence of temporomandibular dysfunction is found in individuals with post-traumatic stress disorder. There is a trend for a larger connection between post-traumatic stress disorder and muscular pain than pain in the temporomandibular joint. The presence of post-traumatic stress disorder modulates the level of physical, psychological and behavioral involvement in individuals with temporomandibular dysfunction, and can predict the onset of this painful conditions. CONCLUSION: The review shows a complex coexistence between post-traumatic stress disorder and painful temporomandibular dysfunction. Keywords: Psychological trauma, Stress disorders, Temporomandibular joint dysfunction syndrome, Trauma. Post-traumatic stress disorder and temporomandibular dysfunction: a review and clinical implications RESUMO JUSTIFICATIVA E OBJETIVOS:Transtorno de estresse pós-traumático é um transtorno incapacitante que pode se desenvolver após exposição ou testemunho de um evento traumáti-co. Evidências demonstram a coexistência entre transtorno de estresse pós-traumático e condições dolorosas crônicas como a disfunção temporomandibular. Este estudo teve como objetivo revisar a literatura para descrever a relação de coexistência entre transtorno de estresse pós-traumático e disfunção temporomandibular. CONTEÚDO: Foi realizada uma busca não sistemática nas bases de dados Pubmed, BVS e LILACS para estudos avaliando a relação entre transtorno de estresse pós-traumático e disfunção temporomandibular. Foram selecionados estudos clínicos publicados nos últimos 10 anos e que apresentassem critério diagnóstico validado para a disfunção temporomandibular e o transtorno de estresse pós-traumático. Seis trabalhos foram incluídos na revisão. Os resultados demonstraram que transtorno de estresse pós-traumático ocorre frequentemente em pacientes com disfunção temporomandibular e ao mesmo tempo, uma maior prevalência de disfunção temporomandibular é encontrada em indivíduos com transtorno de estresse pós-traumático. ...

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“…Individuals with chronic pain often present with comorbid mental health problems including depression, anxiety, substance use and personality disorders (Dersh, Polatin, & Gatchel, 2002), and most commonly with high levels of depression and anxiety (Demyttenaere et al, 2007;Hooten, 2016). There is now a growing body of evidence which finds high rates of comorbidity between chronic pain, traumatic exposure and post-traumatic stress disorder (PTSD), including in individuals seeking treatment for chronic pain (Fishbain, Pulikal, Lewis, & Gao, 2017;Siqveland, Hussain, Lindstrøm, Ruud, & Hauff, 2017). Studies carried out on individuals presenting with chronic pain have found that those who have comorbid PTSD symptoms tend to have higher pre-treatment scores on measures of pain-related outcomes (e.g.…”

Section: Introductionmentioning

confidence: 99%

Treatment outcomes in group‐based cognitive behavioural therapy for chronic pain: An examination of PTSD symptoms

Åkerblom

Perrin

Fischer

et al. 2020

European Journal of Pain

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Background The relevance of post‐traumatic stress disorder (PTSD) symptoms to outcomes of cognitive behavioural therapy (CBT) for chronic pain is unclear. This study examines whether (a) traumatic exposure or the severity of PTSD symptoms at pre‐treatment predicts the outcomes (pain intensity/interference), (b) participation in this treatment is associated with reduced PTSD symptoms and (c) any observed changes in PTSD symptoms are mediated by changes in psychological mechanisms that have been shown to be of importance to PTSD and chronic pain. Methods Participants were 159 chronic pain patients who were consecutively admitted for a multidisciplinary, group‐based CBT program at the Pain Rehabilitation Unit at Skåne University Hospital. A self‐report measure of traumatic exposure and PTSD symptoms was administered before and after treatment, and at a 12‐month follow‐up, along with measures of depression, anxiety, pain intensity, pain interference, psychological inflexibility, life control and kinesiophobia. Results Traumatic exposure and PTSD symptom severity did not predict pain intensity or interference at 12‐month follow‐up. There were no overall significant changes in PTSD symptom severity at post‐treatment or follow‐up, but 24.6% of the participants showed potential clinically significant change at follow‐up. Psychological inflexibility mediated the changes that occurred in PTSD symptoms during treatment. Conclusions Neither traumatic exposure nor baseline symptoms of PTSD predicted the treatment outcomes examined here. Despite improvements in both comorbid depression and anxiety, participation in this pain‐focused CBT program was not associated with improvements in comorbid PTSD. To the extent that changes in PTSD symptoms did occur, these were mediated by changes in psychological inflexibility during treatment. Significance Pain‐focused CBT programs yield clinically meaningful improvements in pain and comorbid symptoms of depression and anxiety, but may have little effect on comorbid PTSD. This raises the issue of whether current pain‐focused CBT programs can be modified to improve outcomes for comorbid conditions, perhaps by better targeting of psychological flexibility, and/or whether separate treatment of PTSD may be associated with improved pain outcomes.

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Chronic Pain Types Differ in Their Reported Prevalence of Post -Traumatic Stress Disorder (PTSD) and There Is Consistent Evidence That Chronic Pain Is Associated with PTSD: An Evidence-Based Structured Systematic Review

Abstract: The results of this systematic review confirmed the hypotheses of this review.

Cited by 130 publications

References 148 publications

Characteristics and Factors Associated With Pain in Older Homeless Individuals: Results From the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) Study

Characteristics and Factors Associated With Pain in Older Homeless Individuals: Results From the Health Outcomes in People Experiencing Homelessness in Older Middle Age (HOPE HOME) Study

Post-traumatic stress disorder and temporomandibular dysfunction: a review and clinical implications

Treatment outcomes in group‐based cognitive behavioural therapy for chronic pain: An examination of PTSD symptoms

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