Self-Reported Pain Complaints among Afghanistan/Iraq Era Men and Women Veterans with Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder

Authors

  • Jennifer Jane Runnals PhD,

    Corresponding author
    1. Mid-Atlantic Mental Illness Research Educational and Clinical Center (VISN 6 MIRECC), Durham, North Carolina
    2. Durham Veterans Affairs Medical Center, Durham, North Carolina
    3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
    • Reprint requests to: Jennifer Jane Runnals, PhD, Mid-Atlantic Mental Illness Research, Education, and Clinical Center (VISN 6 MIRECC), Durham Veterans Affairs Medical Center, 508 Fulton Street, Building 5, Durham, NC 27705, USA. Tel: (919) 286-0411, ext. 4609; Fax: 919-416-5912; E-mail: Jennifer.Runnals@va.gov.

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  • Elizabeth Van Voorhees PhD,

    1. Mid-Atlantic Mental Illness Research Educational and Clinical Center (VISN 6 MIRECC), Durham, North Carolina
    2. Durham Veterans Affairs Medical Center, Durham, North Carolina
    3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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  • Allison T. Robbins BA,

    1. Mid-Atlantic Mental Illness Research Educational and Clinical Center (VISN 6 MIRECC), Durham, North Carolina
    2. Durham Veterans Affairs Medical Center, Durham, North Carolina
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  • Mira Brancu PhD,

    1. Mid-Atlantic Mental Illness Research Educational and Clinical Center (VISN 6 MIRECC), Durham, North Carolina
    2. Durham Veterans Affairs Medical Center, Durham, North Carolina
    3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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  • Kristy Straits-Troster PhD,

    1. Mid-Atlantic Mental Illness Research Educational and Clinical Center (VISN 6 MIRECC), Durham, North Carolina
    2. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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  • Jean C. Beckham PhD,

    1. Mid-Atlantic Mental Illness Research Educational and Clinical Center (VISN 6 MIRECC), Durham, North Carolina
    2. Durham Veterans Affairs Medical Center, Durham, North Carolina
    3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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  • Patrick S. Calhoun PhD

    1. Mid-Atlantic Mental Illness Research Educational and Clinical Center (VISN 6 MIRECC), Durham, North Carolina
    2. Durham Veterans Affairs Medical Center, Durham, North Carolina
    3. Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA
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Abstract

Objective

Research has shown significant rates of comorbidity among posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and pain in prior era veterans but less is known about these disorders in Iraq and Afghanistan war era veterans. This study seeks to extend previous work by evaluating the association among PTSD, MDD, and pain (back, muscle, and headache pain) in this cohort.

Method

A sample of 1,614 veterans, recruited from 2005 to 2010, completed a structured clinical interview and questionnaires assessing trauma experiences, PTSD symptoms, depressive symptoms, and pain endorsement.

Results

Veterans with PTSD endorsed pain-related complaints at greater rates than veterans without PTSD. The highest rate of pain complaints was observed in veterans with comorbid PTSD/MDD. Women were more likely to endorse back pain and headaches but no gender by diagnosis interactions were significant.

Conclusions

Findings highlight the complex comorbid relationship between PTSD, MDD, and pain among Iraq and Afghanistan veterans. This observed association suggests that integrated, multidisciplinary treatments may be beneficial, particularly when multiple psychological and physical health comorbidities are present with pain. Further support may be indicated for ongoing education of mental health and primary care providers about these co-occurring disorders.

Ancillary