United States Veterans with comorbid chronic fatigue syndrome and chronic pain: do women differ from men?

ABSTRACT

Objective

Examine group differences among women and men United States Veterans with chronic fatigue syndrome (CFS) and chronic pain (CP).

Method

Administrative data from the VA Corporate Data Warehouse were derived from a cohort that met criteria for CP in 2018. Differences across sociodemographic characteristics, psychiatric comorbidities, and pain-related healthcare utilization were examined. Analyses included group comparisons (chi-square tests for independence or independent samples t-tests) and effect size differences (Cohen’s d or Cramer’s V).

Results

The period prevalence for comorbid CFS and CP was greater among women Veterans (1.20% vs. 0.61%). Women Veterans with CFS and CP were younger (d = 0.80), more likely to be Black, and less likely to be White (V = 0.13). Women Veterans with CFS and CP were more likely to have fibromyalgia (V = 0.23), headache (V = 0.24), or urogenital, pelvic, and menstrual pain (V = 0.14), and less likely to have neuropathy relative to men; they were also more likely to have depression (V = 0.15) or anxiety (V = 0.13).

Conclusions

Comorbid CFS and CP are more prevalent among women Veterans relative to men. Group differences in pain clusters and psychiatric comorbidities may have implications for clinical offerings to women Veterans with these conditions.

KEYWORDS:

• Chronic fatigue syndrome
• chronic pain
• military veterans
• gender differences

Disclosure statement

No potential conflict of interest was reported by the author(s).

Research involving human participants and/or animals

For this type of study formal consent is not required. This article does not contain any studies with human participants or animals performed by any of the authors. The current study was approved by the University of Iowa Institutional Review Board with a waiver of informed consent. The study was approved by the Iowa City Veterans Administration Research and Development Committee.

Additional information

Funding

This work was funded in part by the U.S. Department of Veterans Affairs, Office of Rural Health (Project #03609), by the U.S. Department of Veterans Affairs, HSR&D through CADRE (Project #CIN 13-412), and by the University of Iowa Ballard & Seashore Dissertation Fellowship (JLA, Spring 2023). The views expressed in this paper are those of the authors and do not necessarily reflect the position or policy of the U.S. Department of Veterans Affairs or the U.S. Government.

Notes on contributors

Jenna L. Adamowicz

Jenna Adamowicz is a graduate student in the Clinical Science program at the University of Iowa and a doctoral intern at VA Connecticut.

Emily B. K. Thomas

Emily Thomas is a Clinical Assistant Professor in the Department of Psychological and Brain Sciences at the University of Iowa.

Brian C. Lund

Brian Lund is a Core Investigator with CADRE at the Iowa City VA.

Mary A. Driscoll

Mary Driscoll is a Clinical Research Psychologist with PRIME at VA Connecticut and an Assistant Professor of Psychiatry at Yale School of Medicine.

Katherine Hadlandsmyth

Katherine Hadlandsmyth is an Investigator with CADRE and VRHRC at the Iowa City VA and an Associate Professor of Anesthesia and Psychiatry and Psychology at the University of Iowa.