title: Myofascial pain of the head and neck among Croatian war veterans treated for depression and posttraumatic stress disorder.
abstract: BACKGROUND
  During the Croatian War of Independence, 1991-1995, Croatian soldiers were exposed to traumatic and stressful events. Certain number of soldiers who took part in the war, developed depression and posttraumatic stress disorder (PTSD). Stress is one of the etiological factors in the development of myofascial pain (MPS), although the mechanism of these processes is not entirely understood. The aims of this study were to determine the frequency of myofascial pain among Croatian war veterans with depression and PTSD, association between MPS and severity of depression, to describe the most common locations of trigger points in the region of head and neck, and to find out if there is any association in frequency between MPS and endotracheal intubation.
  
  
  METHODS
  A total of 101 Croatian war veterans suffering from PTSD and depression participated in the current study. Diagnosis of myofascial pain was based on detailed anamnestic history and careful clinical examination.
  
  
  RESULTS
  Our findings showed a high rate of myofascial pain among Croatian war veterans, with occipital region and right temporal region as the most common places of trigger points. Higher severity of depression was accompanied by a higher percentage of subjects with MPS. Finally, there was no significant association between endotracheal intubation and development of MPS among the war veterans.
  
  
  CONCLUSIONS
  It can be concluded that the rate of myofascial pain among Croatian war veterans is high and therefore it must be considered in patients with depression and PTSD. Moreover, the severity of depressive symptomatology seems to be related to the presence of myofascial pain.
authors.affiliation: Department of Otorhinolaryngology and Head and Neck Surgery, General Hospital "dr. Josip Benčević", Andrije Štampara 42, 35000 Slavonski Brod, Croatia, brunovidakovic@yahoo.com.
authors.forename: Bruno
authors.initials: B
authors.lastname: Vidaković
authors.forename: Ivana
authors.initials: I
authors.lastname: Uljanić
authors.forename: Berislav
authors.initials: B
authors.lastname: Perić
authors.forename: Jakša
authors.initials: J
authors.lastname: Grgurević
authors.forename: Zdenko
authors.initials: Z
authors.lastname: Sonicki
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D017523:Croatia / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology / Q000503:physiopathology*; D006257:Head / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000453:epidemiology / Q000503:physiopathology*; D009333:Neck / Q000503:physiopathology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000503:physiopathology*; D061028:Trigger Points / Q000503:physiopathology*; D014728:Veterans