Disclosures: Don McGeary, PhD: Nothing to disclose

Objective: Disability related to musculoskeletal disorder is complex, often arising from both physical and psychosocial variables. This presentation will describe the outcomes of a large, NIH-funded clinical research trial examining functional rehabilitation in a cohort of Veterans with chronic musculoskeletal pain and comorbid psychiatric symptoms (e.g., depression, PTSD).

Design: Two-arm RCT

Setting: South Texas Veterans Health Care System

Participants  100 U.S. military Veterans with chronic musculoskeletal pain, positive history of persistent opioid use, and comorbid psychiatric symptoms.

Interventions: Participating Veterans were randomly assigned to one of two treatment conditions as follows: 1. Three-week, interdisciplinary functional restoration program 2. Usual care in a large VA medical center

Main Outcome Measures: This NIH-funded research trial includes numerous outcomes, but this presentation will focus specifically on measures of pain-related disability including self-report measures (e.g., Oswestry Disability Index; NIH PROMIS Pain Interference) and objective functional measures (e.g., lifting capacity, grip strength; walking task; sit-to-stand task).

Results: Examination of baseline assessment data shows that PTSD and depression account for a notable portion of disability outcomes even after controlling for pain-related variables (e.g., pain intensity, duration).

Conclusions: Rehabilitation of chronic musculoskeletal pain is more than a physical phenomenon. A patient’s ability to complete functional tasks and their perception of functional capacity is due to both physical variables often addressed in rehabilitative care as well as psychosocial symptoms (e.g., depression and PTSD symptoms). These findings suggest the need for interdisciplinary treatment-planning when the goal of care is to reduce disability.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/the-contribution-of-comorbid-psychiatric-symptoms-to-disability-in-a-cohort-of-veterans-with-chronic-musculoskeletal-pain/