Chronic widespread pain, mental health, and physical role function in OEF/OIF veterans

Drew A Helmer, Helena K Chandler, Karen S Quigley, Melissa Blatt, Ronald Teichman, Gudrun Lange
Pain Medicine 2009, 10 (7): 1174-82

OBJECTIVE: Describe the associations among pain, mental health concerns, and function in veterans of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF).

DESIGN: Retrospective review of self-reported, standardized clinical intake surveys.

SETTING: A multidisciplinary deployment health clinic at a Veterans Affairs (VA) medical center.

PATIENTS: The first 429 veterans of OEF/OIF presenting for clinical evaluation at a deployment health clinic.

OUTCOME MEASURES: Function, measured with the Role Physical (RP) scale of the Veterans RAND (VR)-36 survey, was compared for veterans with and without chronic widespread pain (CWP).

RESULTS: After controlling for age, sex, and positive screens for depression and post-traumatic stress disorder (PTSD), the presence of CWP had a significant, clinically relevant, and independent effect on VR-36 RP (-6.2 points, DeltaR(2) = 0.052, P < 0.001). Mean VR-36 RP normed score was 43.3 (standard deviation 11.9). CWP was common (29%), as were positive mental health screens (PTSD 53%, depression 60%, alcohol misuse 63%).

CONCLUSIONS: In this sample of OEF/OIF veterans, the majority of whom reported good or better general health, CWP was common and related to poorer physical role function, independent of comorbid mental health concerns.

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