THE RELATIONSHIP BETWEEN SYMPTOMS OF POSTTRAUMATIC-STRESS-DISORDER AND PAIN, AFFECTIVE DISTURBANCE AND DISABILITY AMONG PATIENTS WITH ACCIDENT AND NON-ACCIDENT RELATED PAIN

Recent studies have reported a high prevalence of symptoms of post-tra umatic stress disorder (PTSD) among individuals with chronic pain. Stu dies suggest that persons with pain and PTSD also display higher level s of affective disturbance. In the present study we examined self-repo rts of pain, affective disturbance, and disability among pain patients with and without symptoms of PTSD, Patients without PTSD symptoms wer e further subdivided into persons whose pain was the result of an acci dent or insidious in onset, Thus, three groups were examined: (1) pers ons with accident related pain and high PTSD symptoms (Accident/High P TSD); (2) persons with no or few symptoms of PTSD whose pain was accid ent related (Accident/Low PTSD); and (3) patients whose pain was not a ccident related and did not have PTSD symptoms (No Accident). No Accid ent patients were older than persons with accident related injuries, a nd both accident related pain groups were more likely than No Accident patients to be involved in litigation or receiving compensation. Thus , these variables were controlled for in the statistical analyses, Sel f-report of pain was also included as a covariate in the analyses exam ining group differences in affective disturbance and disability. Accid ent/High PTSD patients displayed higher levels of self-reported pain c ompared to the other two groups. The Accident/High PTSD group also had the highest levels of affective disturbance. Both accident groups ten ded to report greater disability compared to patients whose pain was n ot accident related, These findings suggest that PTSD symptoms in chro nic pain patients are associated with increased pain and affective dis tress. Accident related pain, even without the presence of PTSD sympto ms, appears to be associated with greater disability, The results indi cate that the identification and treatment of PTSD symptoms in refract ory pain patients may be a critical albeit subtle factor in the effect ive management of suffering and disability in this population.