{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T20:15:55Z","timestamp":1793218555397,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T00:00:00Z","timestamp":1709769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women are more likely to experience multiple overlapping pain conditions (MOPCs) relative to men. Post\u2010traumatic stress disorder can negatively impact the severity and trajectory of chronic pain and its treatment. Specific associations between gender, post\u2010traumatic stress disorder (PTSD), and MOPCs require further examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cohort of all Veterans in 2021 who met criteria for one or more of 12 chronic pain types was created using national Veterans Health Administration administrative data. MOPCs were defined as the number of pain types for which each patient met criteria. Multivariable logistic regression models estimated gender differences in frequency for each of the 12 pain subtypes, after controlling for demographics and comorbidities. Negative binomial regression was used to estimate gender differences in the count of MOPCs and to explore moderation effects between gender and PTSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort included 1,936,859 Veterans with chronic pain in 2021, which included 12.5% women. Among those with chronic pain, women Veterans had higher rates of MOPCs (mean\u2009=\u20092.3) relative to men (mean\u2009=\u20091.9): aIRR\u2009=\u20091.31, 95% CI: 1.30\u20131.32. PTSD also served as an independent risk factor for MOPCs in adjusted analysis (aIRR\u2009=\u20091.23, 95% CI: 1.23\u20131.24). The interaction term between gender and PTSD was not significant (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.87). Independent of PTSD, depressive disorders also served as a strong risk factor for MOPCs (aIRR\u2009=\u20091.37, 95% CI: 1.36\u20131.37).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individuals with MOPCs and PTSD may have complex treatment needs. They may benefit from highly coordinated trauma\u2010sensitive care and integrated interventions that simultaneously address pain and PTSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>Women were significantly more likely than men to experience MOPCs. PTSD was also significantly, independently, associated with MOPCs. Patients, particularly women, may benefit from tailored interventions that address both trauma and MOPCs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.2258","type":"journal-article","created":{"date-parts":[[2024,3,7]],"date-time":"2024-03-07T07:53:21Z","timestamp":1709798001000},"page":"1311-1319","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Veterans with chronic pain: Examining gender differences in pain type, overlap, and the impact of post\u2010traumatic stress disorder"],"prefix":"10.1002","volume":"28","author":[{"given":"Katherine","family":"Hadlandsmyth","sequence":"first","affiliation":[{"name":"VA Office of Rural Health (ORH) Veterans Rural Health Resource Center\u2010Iowa City (VRHRC\u2010IC), Iowa City VA Health Care System  Iowa City Iowa USA"},{"name":"Center for Access &amp; Delivery Research and Evaluation (CADRE) Iowa City VA Health Care System  Iowa City Iowa USA"},{"name":"Department of Anesthesia University of Iowa Carver College of Medicine  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary A.","family":"Driscoll","sequence":"additional","affiliation":[{"name":"Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center VA Connecticut Healthcare System  West Haven Connecticut USA"},{"name":"Department of Psychiatry Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole L.","family":"Johnson","sequence":"additional","affiliation":[{"name":"VA Office of Rural Health (ORH) Veterans Rural Health Resource Center\u2010Iowa City (VRHRC\u2010IC), Iowa City VA Health Care System  Iowa City Iowa USA"},{"name":"Center for Access &amp; Delivery Research and Evaluation (CADRE) Iowa City VA Health Care System  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine G.","family":"Mares","sequence":"additional","affiliation":[{"name":"Center for Access &amp; Delivery Research and Evaluation (CADRE) Iowa City VA Health Care System  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle A.","family":"Mengeling","sequence":"additional","affiliation":[{"name":"VA Office of Rural Health (ORH) Veterans Rural Health Resource Center\u2010Iowa City (VRHRC\u2010IC), Iowa City VA Health Care System  Iowa City Iowa USA"},{"name":"Center for Access &amp; Delivery Research and Evaluation (CADRE) Iowa City VA Health Care System  Iowa City Iowa USA"},{"name":"Department of Internal Medicine University of Iowa Carver College of Medicine  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily B. K.","family":"Thomas","sequence":"additional","affiliation":[{"name":"VA Office of Rural Health (ORH) Veterans Rural Health Resource Center\u2010Iowa City (VRHRC\u2010IC), Iowa City VA Health Care System  Iowa City Iowa USA"},{"name":"Department of Psychological and Brain Sciences University of Iowa College of Liberal Arts and Sciences  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonya B.","family":"Norman","sequence":"additional","affiliation":[{"name":"National Center for PTSD  White River Junction Vermont USA"},{"name":"University of California San Diego School of Medicine  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Lund","sequence":"additional","affiliation":[{"name":"VA Office of Rural Health (ORH) Veterans Rural Health Resource Center\u2010Iowa City (VRHRC\u2010IC), Iowa City VA Health Care System  Iowa City Iowa USA"},{"name":"Center for Access &amp; Delivery Research and Evaluation (CADRE) Iowa City VA Health Care System  Iowa City Iowa USA"},{"name":"Department of Biostatistics University of Iowa College of Public Health  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000561"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopsych.2013.04.006"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/070674370204701004"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pnaa007"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/usaa052"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2008.05.006"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/pme.12744"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.11.001"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000567"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.07.021"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22861"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jrh.12646"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2017.01.008"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0b013e31816ba437"},{"key":"e_1_2_9_16_1","volume-title":"Education, and research","author":"Institute of Medicine (US) Committee on Advancing Pain Research, C., and Education","year":"2011"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.02.003"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916\u2010019\u20100828\u20103"},{"key":"e_1_2_9_19_1","unstructured":"Larsen S. 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