An Examination of Chronic Pain Conditions and Mental Health Correlates in a Population-Based Survey of Canadian Forces Personnel

Abstract

Introduction: Chronic pain conditions and mental disorders are highly prevalent in military and veteran populations. Despite this, few investigations have been conducted examining the co-morbidity between chronic pain conditions and specific mental disorders. Methods: Data were analyzed from the 2013 Canadian Forces Mental Health Survey (CFMHS) using the regular member population (n = 6696). Diagnostic interviews assessed mental disorders and participants self-reported chronic pain conditions (i.e., arthritis, back problems, musculoskeletal conditions, migraines and traumatic brain injury (TBI)/concussion) and indicators of pain severity. Multivariate logistic regression models assessed associations between the chronic pain conditions and mental disorders. Weighted cross-tabulations and moderation analyses assessed the prevalence of pain severity indicators in comorbid relationships compared to the physical condition alone. Results: 25% of participants endorsed chronic pain. In the most stringent model that additionally adjusted for comorbid mental disorders, all assessed chronic pain conditions were significantly associated with PTSD (odds ratio range (ORR): 1.86-3.57, p < 0.01). Further, back problems remained significantly associated with all mental disorders apart from AUD (ORR: 1.40-2.17, p < 0.05). Cross-tabulations demonstrated greater pain severity indicators among those with mental disorders and comorbid physical conditions, compared to physical conditions alone. Formal moderation analyses showed a significant relationship between migraine and activity limitation on PTSD. Interpretation: Chronic pain conditions are prevalent and co-occur with mental disorders among Canadian regular force members. Results are particularly robust for PTSD and suggest that comorbidity with migraines, in particular, results in greater activity limitations than migraine alone.