Trauma and posttraumatic stress disorder in transcultural patients with chronic pain.

BACKGROUND: Traumatic events are commonly experienced in the general population and can lead to both psychological and physical consequences. While some may process the experienced event without developing trauma related symptoms in the long term, others develop persistent symptomatology in the form of chronic pain depending on the type of trauma as well as various other risk factors. OBJECTIVE: The aim of this study was to examine the relationship of the number of lifetime traumas and chronic pain in a sample of transcultural patients to further develop existing research highlighting an association between the number of traumas and chronic pain that may be independent of a categorical diagnosis of PTSD. METHODS: Using a case-control design, this study compared 29 chronic pain patients (Gerbershagen II/III) born in former Yugoslavia (21 female; age: 52.5 years, SD 7.3) to 21 patients of a general psychiatric sample who were matched by age- (±5 years), migratory-background, and gender. The number of traumas and PTSD symptomatology were assessed using the Harvard Trauma Questionnaire (HTQ). Somatisation, social dysfunction and anxiety were assessed by the General Health Questionnaire 28 (GHQ-28). The Beck Depression Inventory (BDI) was used to determine the presence of depression. RESULTS: 96.9 % of the chronic pain patients reported at least one traumatic event compared to 76.2 % within the control group (p = 0.029). Likewise, the mean number of reported traumas was significantly higher among the chronic pain group at 12 vs. 7 respectively (p = 0.024). Regarding anxiety, depression and social dysfunction, no significant difference between the two groups was found. CONCLUSIONS: Chronic pain patients with migratory background report an unusually high number of traumatic events. Clinicians should carefully screen for trauma history in this group of patients. The present study supports prior research suggesting a cumulative effect of trauma on chronic pain.

[Association between fear of stigma, depressive and anxiety symptoms in patients with somatoform pain disorder]. / Zusammenhang zwischen Stigmabefürchtung, depressiver und Angstsymptomatik bei Patienten mit somatoformer Schmerzstörung.

OBJECTIVES: There is still poor acceptance for pain without somatic causes, and patients with somatoform pain disorder carry a stigma per se. The aim of this study was to identify predictors of fear of stigma including depression, anxiety and somatisation among patients with somatoform pain disorder. METHODS: 132 patients with somatoform pain disorder were investigated by using the Link Stigma Questionnaire, the Beck Depression Inventory, the State-Trait Anxiety Inventory, the Whiteley-Index, and the Checklist for Somatisation. RESULTS: Multiple linear regression analysis showed a significant positive association between fear of stigma and symptoms of depression and a negative association with patients' age. CONCLUSIONS: This is one of the first studies investigating this question among patients with somatoform pain disorder. Findings might indicate the importance of depressive symptoms for developing fear of stigma.