Prevalence of Posttraumatic Stress Disorder in Persons with Chronic Pain: A Meta-analysis

被引:117
作者
Siqveland, Johan [1 ,2 ,3 ]
Hussain, Ajmal [1 ]
Lindstrom, Jonas Christoffer [4 ]
Ruud, Torleif [1 ,3 ]
Hauff, Edvard [3 ,5 ]
机构
[1] Akershus Univ Hosp, Div Mental Hlth Serv, Dept Res & Dev, Lorenskog, Norway
[2] Reg Resource Ctr Traumat Stress & Suicide Prevent, Oslo, Norway
[3] Univ Oslo, Inst Clin Med, Oslo, Norway
[4] Akershus Univ Hosp, Hlth Serv Res Unit, Lorenskog, Norway
[5] Oslo Univ Hosp, Oslo, Norway
关键词
posttraumatic stress disorder; PTSD; chronic pain; systematic review; meta-analysis; prevalence; DSM-IV DISORDERS; FIBROMYALGIA SYNDROME; ANXIETY DISORDERS; PSYCHIATRIC-DISORDERS; MENTAL-DISORDERS; TRAUMATIC EVENTS; WIDESPREAD PAIN; AXIS-I; COMORBIDITY; PTSD;
D O I
10.3389/fpsyt.2017.00164
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: To summarize evidence for the prevalence of posttraumatic stress disorder (PTSD) among persons with chronic pain (CP). Methods: We searched databases for studies published between January 1995 and December 2016, reporting the prevalence of PTSD in persons with CP. Two reviewers independently extracted data and assessed the risk of bias. We calculated the pooled prevalence using a random-effects model and performed subgroup analyses according to pain location, the population and assessment method. Results: Twenty-one studies were included and the PTSD prevalence varied from 0-57%, with a pooled mean prevalence of 9.7%, 95% CI (5.2-17.1). In subgroup analysis, the PTSD prevalence was 20.5%, 95% CI (9.5-39.0) among persons with chronic widespread pain, 11.2%, 95% CI (5.7-22.8) among persons with headache, and 0.3%, 95% CI (0.0-2.4) among persons with back pain. The prevalence in clinical populations was 11.7%, 95% CI (6.0-21.5) and in non-clinical populations 5.1%, 95% CI (0.01-17.2). In studies of self-reported PTSD symptoms, PTSD prevalence was 20.4%, 95% CI (10.6-35.5), and in studies where structured clinical interviews had been used to assess PTSD its prevalence was 4.5%, 95% (CI 2.1-9.3). The risk of bias was medium for most studies and the heterogeneity was high (I-2 = 98.6). Conclusion: PTSD is overall more prevalent in clinical cohorts of persons with CP and particularly in those with widespread pain, but may not always be more prevalent in non-clinical samples of persons with CP, compared to the general population. There is a large heterogeneity in prevalence across studies. Future research should identify sources of heterogeneity and the mechanisms underlying the comorbidity of the two conditions.
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页数:9
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