Chronic Widespread Pain, Mental Health, and Physical Role Function in OEF/OIF Veterans

Abstract

Objective. Describe the associations among pain, mental health concerns, and function in veterans of Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Design. Retrospective review of self-reported, standardized clinical intake surveys. Setting. A multidisciplinary deployment health clinic at a Veterans Affairs (VA) medical center. Patients. The first 429 veterans of OEF/OIF presenting for clinical evaluation at a deployment health clinic. Outcome Measures. Function, measured with the Role Physical (RP) scale of the Veterans RAND (VR)-36 survey, was compared for veterans with and without chronic widespread pain (CWP). Results. After controlling for age, sex, and positive screens for depression and post-traumatic stress disorder (PTSD), the presence of CWP had a significant, clinically relevant, and independent effect on VR-36 RP (−6.2 points, ΔR² = 0.052, P < 0.001). Mean VR-36 RP normed score was 43.3 (standard deviation 11.9). CWP was common (29%), as were positive mental health screens (PTSD 53%, depression 60%, alcohol misuse 63%). Conclusions. In this sample of OEF/OIF veterans, the majority of whom reported good or better general health, CWP was common and related to poorer physical role function, independent of comorbid mental health concerns.