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首页> 外文期刊>Journal of Rehabilitation Research and Development >Does comorbid chronic pain affect posttraumatic stress disorderdiagnosis and treatment? Outcomes of posttraumatic stress disorderscreening in Department of Veterans Affairs primary care
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Does comorbid chronic pain affect posttraumatic stress disorderdiagnosis and treatment? Outcomes of posttraumatic stress disorderscreening in Department of Veterans Affairs primary care

机译：合并症慢性疼痛是否会影响创伤后应激障碍的诊断和治疗？退伍军人事务部初级保健部门的创伤后应激障碍筛查结果

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Because posttraumatic stress disorder (PTSD) isboth prevalent and underrecognized, routine primary carebasedscreening for PTSD has been implemented across the VeteransHealth Administration. PTSD is frequently complicated by thepresence of comorbid chronic pain, and patients with both conditionshave increased symptom severity and poorer prognosis.Our objective was to determine whether the presence of painaffects diagnosis and treatment of PTSD among Department ofVeterans Affairs (VA) patients who have a positive PTSDscreening test. This retrospective cohort study used clinical andadministrative data from six Midwestern VA medical centers.We identified 4,244 VA primary care patients with a positivePTSD screen and compared outcomes for those with and withouta coexisting pain diagnosis. Outcomes were three clinicallyappropriate responses to positive PTSD screening (1) mentalhealth visit, (2) PTSD diagnosis, and (3) new selective serotoninreuptake inhibitor (SSRI) prescription. We found that patientswith coexisting pain had a lower rate of mental health visits thanthose without pain (hazard ratio 0.889, 95% confidence interval0.821–0.962). There were no significant differences in therate of PTSD diagnosis or new SSRI prescription betweenpatients with and without coexisting pain.
机译：由于创伤后应激障碍（PTSD）既普遍存在，又未得到充分认识，因此，退伍军人健康管理局已对PTSD进行常规的基于初级保健的筛查。并发性慢性疼痛的存在常常使PTSD复杂化，这两种情况的患者症状严重程度均增加，预后也较差。我们的目的是确定退伍军人事务部（VA）阳性的患者是否存在影响PTSD的诊断和治疗PTSD筛选测试。这项回顾性队列研究使用了来自中西部VA六个医疗中心的临床和行政管理数据。我们确定了4,244例PTSD筛查阳性的VA初级保健患者，并比较了有或没有共存疼痛诊断的患者的结局。结果是对PTSD筛查呈阳性的三种临床上适当的反应（1）心理健康就诊，（2）PTSD诊断和（3）新的选择性5-羟色胺再摄取抑制剂（SSRI）处方。我们发现与疼痛并存的患者比没有疼痛的患者具有更低的心理健康就诊率（危险比0.889，95％置信区间0.821-0.962）。有疼痛和无疼痛并存的患者之间PTSD诊断率或新SSRI处方率均无显着差异。

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