Consideration of sleep dysfunction in rehabilitation.
Background. Chronic injury-related pain could be influenced by psychological symptoms such as depression, anxiety, and stress that also affect daily life. Methods. Patients with chronic pain caused by an injury (n = 86) aged 18-65 years referred to the Pain Rehabilitation Clinic at the Umeå University Hospital answered a set of questionnaires to assess pain intensity, depression, anxiety, posttraumatic stress, sleep disturbance, and fatigue. Results. A significantly higher proportion of women (47.5%) reported depression (Hospital Anxiety and Depression Scale (HAD)) than men (22.2%). In all patients anxiety (HAD) was reported by 39.5% and moderate/severe posttraumatic stress (Impact of Event Scale) by 30.2%. A majority reported sleep disturbance (84.9%) and fatigue (90.7%). Significant relationships were found between posttraumatic stress and depression and anxiety. Conclusion. These findings indicate the importance of assessing and treating psychological symptoms associated with chronic pain as the result of trauma.