Gender is not a mediating factor in the relationship between pain and post traumatic stress disorder

1. Post-traumatic stress disorder (PTSD) symptoms were associated with higher levels of chronic pain, pain catastrophizing, and pain interference amongst U.S. veterans.

2. No significant gender differences were found in the associations between PTSD symptoms and pain outcomes. 

Evidence Rating Level: 2 (Good) 

Post-traumatic stress disorder (PTSD) and chronic pain are highly prevalent comorbid conditions in both veterans and civilians. Patients dually burdened by both PTSD and chronic pain experience more severe psychiatric impairments and incur a greater cost to the healthcare system. Few studies have enrolled enough women to test the gender difference in pain outcomes (pain catastrophizing, interference, and intensity) relative to PTSD symptoms. In this secondary analysis of a randomized clinical trial, a linear regression model was used to analyze 421 men and 386 women Veterans with chronic pain who provided complete data on PTSD symptoms and pain outcomes. PTSD symptoms were associated with higher levels of pain catastrophizing (0.57, 95% CI [0.51, 0.63]), pain intensity (0.30, 95% CI [0.24, 0.37]), and pain interference (0.46, 95% CI [0.39, 0.52]). Gender differences were not found using crude models or those adjusted for sociodemographic characteristics (all interaction p-values<0.05). While women Veterans had higher average PTSD symptoms cores, pain catastrophizing, pain intensity, and pain interference, no significant differences were present in interaction models between PTSD and chronic pain. Differences could be minimized due to the strict inclusion criteria which could skew participants to be more similar than the true Veteran population. Overall, study findings suggest a correlative relationship between PTSD symptoms and both the sensation and cognitive processing of pain, with no sex-related differences observed. 

Click to read the study in PLOSONE

Image: PD

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