(522) The effect of psychiatric comorbidities on treatment outcomes of veterans participating in an interdisciplinary chronic pain rehabilitation program

Abstract

Psychiatric comorbidities have been shown to adversely affect chronic pain and its treatment, but research is limited regarding its impact on different treatment approaches, particularly interdisciplinary chronic pain rehabilitation. Research on this topic involving veterans is minimal. This study examined the effects of psychiatric comorbidities on veterans’ response to an interdisciplinary outpatient chronic pain rehabilitation program (OCPRP). One hundred patients who completed a VA OCPRP were randomly selected. Participants with psychiatric diagnoses were identified and categorized into one of two groups. Group 1 consisted of 21 patients with no psychiatric diagnoses, and Group 2 included 24 patients with 2 or more psychiatric diagnoses. The 2 groups did not differ on any baseline characteristics, with the exception of non-pain-related psychiatric medications. Patients completed the Pain Outcomes Questionnaire (POQ) and Sleep Problems Questionnaire at intake and discharge, measuring pain intensity, vitality, pain-related negative mood, mobility, pain-related fears, activities of daily living (ADLs), and sleep impairment, with opioid usage also monitored. A MANOVA demonstrated a significant main effect for Time and Group, with a trend effect for the Time x Group interaction (p < .1). Univariate ANOVA’s showed a significant (p < .05) main effect for the Time and Group factors on all POQ and sleep subscale measures except ADLs. Significant Time x Group interactions were also found, with Group 2 patients showing higher pre-and post-treatment scores for negative mood, vitality, and fear, as well as significantly less improvement at discharge in pain, negative mood, and mobility. No significant differences were observed between groups regarding opioid usage. These findings suggest that psychiatric comorbidities have a significant effect on pain rehabilitation treatment outcomes among veterans. Additional research with larger samples, objective measures of functioning, better controls for non-pain psychiatric medications, and longer term follow-up is warranted. Psychiatric comorbidities have been shown to adversely affect chronic pain and its treatment, but research is limited regarding its impact on different treatment approaches, particularly interdisciplinary chronic pain rehabilitation. Research on this topic involving veterans is minimal. This study examined the effects of psychiatric comorbidities on veterans’ response to an interdisciplinary outpatient chronic pain rehabilitation program (OCPRP). One hundred patients who completed a VA OCPRP were randomly selected. Participants with psychiatric diagnoses were identified and categorized into one of two groups. Group 1 consisted of 21 patients with no psychiatric diagnoses, and Group 2 included 24 patients with 2 or more psychiatric diagnoses. The 2 groups did not differ on any baseline characteristics, with the exception of non-pain-related psychiatric medications. Patients completed the Pain Outcomes Questionnaire (POQ) and Sleep Problems Questionnaire at intake and discharge, measuring pain intensity, vitality, pain-related negative mood, mobility, pain-related fears, activities of daily living (ADLs), and sleep impairment, with opioid usage also monitored. A MANOVA demonstrated a significant main effect for Time and Group, with a trend effect for the Time x Group interaction (p < .1). Univariate ANOVA’s showed a significant (p < .05) main effect for the Time and Group factors on all POQ and sleep subscale measures except ADLs. Significant Time x Group interactions were also found, with Group 2 patients showing higher pre-and post-treatment scores for negative mood, vitality, and fear, as well as significantly less improvement at discharge in pain, negative mood, and mobility. No significant differences were observed between groups regarding opioid usage. These findings suggest that psychiatric comorbidities have a significant effect on pain rehabilitation treatment outcomes among veterans. Additional research with larger samples, objective measures of functioning, better controls for non-pain psychiatric medications, and longer term follow-up is warranted.