Presented at the 2013 AAPM Annual Meeting« Back

The Role of Post-Traumatic Stress on Chronic Pain Outcomes: Efficacy of Intensive Interdisciplinary Pain Rehabilitation for Patients with PTSD

Matthew Schumann, BA, matthew.schumann@mnsu.edu¹, Cynthia Townsend, PhD², (1) Minnesota State University, Mankato, Minnesota, (2) Mayo Clinic, Rochester, Minnesota

Introduction: There is limited research investigating interdisciplinary pain rehabilitation treatment for chronic pain patients with co-morbid PTSD. This study aims to determine the efficacy of rehabilitative treatment for patients with PTSD compared to patients without PTSD. Methods and Materials: This retrospective study was approved by the Mayo Clinic IRB and compared a sample of 82 consecutive patients with PTSD with a matched sample of patients without PTSD enrolled in a 3-week interdisciplinary rehabilitation program. The two sample groups were matched on age, gender, and admission date. The Mini-International Neuropsychiatric Interview identified patients with PTSD. Pain Anxiety Symptoms Scale, Pain Catastrophizing Scale, Multidimensional Pain Inventory and Center for Epidemiological Studies-Depression scale were used to assess functioning upon admission and discharge. Results: Upon admission, PTSD patients endorsed significantly greater depression (p<.001), pain-anxiety (p<.001) and pain catastrophizing (p<.001) and lower perceived life control (p<.001) and general activity (p<.05) than non-PTSD patients. Upon program completion, both PTSD and non-PTSD patients made significant rehabilitative gains (p<.01) but the PTSD group continued to report greater pain-anxiety symptoms (p<.05) and depression (p<.001), and lower life control (p<.001) and general activity (p<.05). There were no significant differences in ethnicity, work status, opioid use. Conclusions: Interdisciplinary pain rehabilitation treatment significantly improves anxiety symptoms, depression and functioning, but patients with PTSD continued to experience greater distress and limited gains. Diagnosis and treatment of PTSD should be implemented within interdisciplinary rehabilitation programs. References: 1) El-Gabalawy, R., Mackenzie, C.S., Shooshtari, S., & Sareen, J. (2011). Comorbid physical health conditions and anxiety disorders: a population-based exploration of prevalence and health outcomes among older adults. General Hospital Psychiatry, 33, 556-564 2) Shaw, W.S., Means-Christensen, A.J., Slater, M.A., Webster, J.S., Patterson, T.L., Grant, I., Garfin, S.R., Wahlgren, D.R., Patel, S., & Atkinson, J.H. (2010). Psychiatric disorders and risk of transition to chronicity in men with first onset low back Pain, Pain Medicine, Vol. 11, No. 9, pp. 1391-1400, 2010

Funding: None