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Volume 46 Number 6, 2009
   Pages 697 — 702

Abstract —  Prevalence of chronic pain, posttraumatic stress disorder, and persistent postconcussive symptoms in OIF/OEF veterans: Polytrauma clinical triad

Henry L. Lew, MD, PhD;1-3* John D. Otis, PhD;4 Carlos Tun, MD;1-2 Robert D. Kerns, PhD;5 Michael E. Clark, PhD;6 David X. Cifu, MD7

1Physical Medicine and Rehabilitation (PM&R) Service, Department of Veterans Affairs (VA) Boston Healthcare System, Boston, MA; 2Harvard Medical School, Boston, MA; 3Defense and Veterans Brain Injury Center (DVBIC) Site, Boston, MA; 4Pain Research Program, VA Boston Healthcare System, Boston, MA; 5PRIME Center, VA Connecticut Healthcare System, West Haven, CT; 6Chronic Pain Rehabilitation Program, James A. Haley Veterans' Hospital, Tampa, FL; 7PM&R Service, Richmond VA Medical Center, Richmond, VA

Abstract —  This study examines the prevalence and coprevalence with which returning Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) veterans were reporting symptoms consistent with chronic pain, posttraumatic stress disorder (PTSD), and persistent postconcussive symptoms (PPCS). The medical records of 340 OIF/OEF veterans seen at a Department of Veterans Affairs Polytrauma Network Site were comprehensively reviewed. Analyses indicated a high prevalence of all three conditions in this population, with chronic pain, PTSD, and PPCS present in 81.5%, 68.2%, and 66.8%, respectively. Only 12 of the veterans (3.5%) had no chronic pain, PTSD, or PPCS. The frequency at which these three conditions were present in isolation (10.3%, 2.9%, and 5.3%, respectively) was significantly lower than the frequency at which they were present in combination with one another, with 42.1% of the sample being diagnosed with all three conditions simultaneously. The most common chronic pain locations were the back (58%) and head (55%). These results underscore the complexity of the presenting complaints in OIF/OEF veterans and support the importance of a multidisciplinary team approach to assessment and treatment.

Key words: brain injuries, explosions, Iraq, military personnel, pain, posttraumatic stress disorder, rehabilitation, veterans, war, wounds and injuries.

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