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Adult- Health Psychology / Behavioral Medicine

Comparing psychiatric comorbidities and pain-related healthcare utilization across Veterans with three chronic pain conditions

(PS1-82) Comparing Psychiatric Comorbidities and Pain-related Healthcare Utilization Across Veterans with Three Chronic Pain Conditions

Friday, November 15, 2024
8:30 AM – 9:30 AM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text: Chronic fatigue syndrome (CFS) is a debilitating chronic condition. Pain symptoms are common and included in the diagnostic criteria for CFS; however, they are not required for diagnosis. Both CFS and chronic pain conditions are associated with increases in psychiatric conditions (such as depression and anxiety) and healthcare usage. However, it is unclear if there is an increased risk if someone is diagnosed with both conditions. The current study compared the prevalence of psychiatric comorbidities and pain-related healthcare utilization across Veterans with three chronic pain conditions: CFS with comorbid chronic pain, fibromyalgia (FM), and temporomandibular disorder (TMD). The study was a population-based investigation utilizing 2018-2019 Veterans health administration data from the VA Corporate Data Warehouse. This study was pre-registered on the Open Science Framework: https://osf.io/c2tzp#. Multivariate negative binomial and logistic regression analyses examined whether Veterans with CFS and comorbid chronic pain had an increased or decreased likelihood of receiving a psychiatric comorbidity diagnosis (depressive, anxiety, or posttraumatic stress disorders) or an increased or decreased likelihood of utilizing pain-related healthcare services (visits in VA primary care, mental health, or pain clinics) compared with VA-using peers diagnosed with FM or TMD. As a population-based study, sample sizes for the three chronic pain conditions were large (range: 15,248-63,519). Therefore, a priori levels of clinical significance were determined, and logistic regressions were considered clinically significant if a statistically significant difference was found (p< 0.05) and a 10% increase or decrease was met (odds ratio = >1.10 or < 0.90). Findings revealed that Veterans with FM and TMD have similar rates of anxiety (aOR = 0.93 [0.89, 0.97], 0.99 [0.89, 0.98], respectively) and posttraumatic stress disorder (aOR = 1.08 [1.04, 1.13], 0.99 [0.94, 1.03], respectively) relative to Veterans with comorbid CFS and chronic pain. However, these Veterans were less likely to have a depressive disorder diagnosis compared with Veterans experiencing CFS and chronic pain (aOR = 0.88 [0.84, 0.91], 0.69 [0.66, 0.72], respectively). Veterans across all three groups had similar usage of primary care clinics (aIRR = 1.07 [1.06, 1.09], 0.91 [0.89, 0.93]), but Veterans with FM were more likely to use pain clinics and mental health care (aOR = 1.99 [1.89, 2.11], 1.36 [1.28, 1.45], respectively), whereas Veterans with TMD were less likely to use these same services (aOR = 0.91 [0.86, 0.97], 0.68 [0.63, 0.73], respectively) relative to Veterans with CFS and chronic pain. The findings from the current study highlight that Veterans with comorbid CFS and chronic pain are more likely to have a depressive disorder diagnosis compared to their chronic pain peers yet are less likely to utilize pain-specific specialty services within pain clinics or mental health clinics. Future research may benefit from examinations into referrals and adoption rates for such services as well as qualitative investigations into patient and provider impressions of care for comorbid CFS and chronic pain syndromes.