(336/934): Clinical relationship between chronic pain and chronic combat related post traumatic stress disorder

Abstract

Recent research and clinical practice suggest that there is strong interdependence between chronic pain and chronic post-traumatic stress disorder (PTSD), and there are several pathways by which both disorders may be involved in the escalation of symptoms and distress following trauma. The authors analysed the relationship between chronic pain and chronic combat-related PTSD among Croatian veterans. The 150 patients with chronic combat-related PTSD and chronic pain, who were treated at the Osijek University Clinical Hospital during year 2005, were selected as the sample for this study. On the base of clinical interviews, medical records and different self reported questionnaires (Mississippi Scale for combat-related PTSD, Mc Gill Pain Questionnaire, Pain Outcomes Questionnaire, Brief Pain Inventory, Beck Depression Inventory) the authors analysed the characteristics of chronic pain and PTSD, as well as pharmacological and non-pharmacological approaches that were used in the treatment. Combat veterans with PTSD reported in descending order back pain, headache pain, limb pain and torso pain. Intrusive symptoms of PTSD were significantly related to pain intensity and pain disability. Anxiety and depression were highly correlated to pain. All patients were treated with psychotropic drugs as well as with analgetics. The high levels of pain symptoms in PTSD patients suggests that pain is an important issue that needs to be recognized and treated by multidisciplinary approach. Rational polypharmacy may be essential to achieving and maintaining the full recovery of both disorders. But, pharmacotherapy alone is no sufficient to provide complete remission, and non-pharmacological methods have also very important place in the treatment of those patients.