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Pain in the aftermath of trauma is a risk factor for post-traumatic stress disorder

Published online by Cambridge University Press:  10 September 2007

S. B. Norman ,
M. B. Stein ,
J. E. Dimsdale  and
D. B. Hoyt
S. B. Norman*
Affiliation:
Departments of Psychiatry and Surgery (Division of Trauma Surgery), University of California, San Diego, CA, USA
M. B. Stein
Affiliation:
Departments of Psychiatry and Surgery (Division of Trauma Surgery), University of California, San Diego, CA, USA
J. E. Dimsdale
Affiliation:
Departments of Psychiatry and Surgery (Division of Trauma Surgery), University of California, San Diego, CA, USA
D. B. Hoyt
Affiliation:
Departments of Psychiatry and Surgery (Division of Trauma Surgery), University of California, San Diego, CA, USA
*
*Address for correspondence: S. B. Norman, Ph.D., University of California, San Diego, 140 Arbor Drive (0851), San Diego, CA 92103, USA. (Email: [email protected])
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Abstract

Background

Identifying risk factors for the development of post-traumatic stress disorder (PTSD) is important for understanding and ultimately preventing the disorder. This study assessed pain shortly after traumatic injury (i.e. peritraumatic pain) as a risk factor for PTSD.

Method

Participants (n=115) were patients admitted to a Level 1 Surgical Trauma Center. Admission to this service reflected a severe physical injury requiring specialized, emergent trauma care. Participants completed a pain questionnaire within 48 h of traumatic injury and a PTSD diagnostic module 4 and 8 months later.

Results

Peritraumatic pain was associated with an increased risk of PTSD, even after controlling for a number of other significant risk factors other than acute stress disorder symptoms. An increase of 0.5 s.d. from the mean in a 0–10 pain rating scale 24–48 h after injury was associated with an increased odds of PTSD at 4 months by more than fivefold, and at 8 months by almost sevenfold. A single item regarding amount of pain at the time of hospital admission correctly classified 65% of participants.

Conclusions

If these findings are replicated in other samples, high levels of peritraumatic pain could be used to identify individuals at elevated risk for PTSD following traumatic injury.

Keywords

PainPTSDrisk factorstrauma
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 4 , April 2008 , pp. 533 - 542
Copyright
Copyright © Cambridge University Press 2007

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