Chronic pain with comorbid post-traumatic stress disorder and major depressive disorder: a case report

Chronic pain is a complex biopsychosocial condition that is frequently exacerbated by psychiatric comorbidity, leading to poorer clinical outcomes as well as increased disability and suicide risk. This case report describes a 44-year-old woman with chronic headache, vertigo, trigeminal neuralgia, and chronic low back pain who also developed post-traumatic stress disorder and major depressive disorder with psychotic features following prolonged exposure to domestic violence and cumulative psychosocial stressors. The patient had previously received fragmented care across multiple specialties without integrated psychiatric management. The initiation of combined pharmacological treatment and psychotherapy targeting both neuropathic pain and psychiatric symptoms resulted in a more comprehensive understanding of her condition and improved symptom control. This case illustrates the strong bidirectional interaction between chronic pain and psychiatric disorders, mediated by interconnected neurobiological mechanisms, psychosocial processes, and trauma-related stress, and underscores the importance of early identification of psychiatric comorbidity and integrated multidisciplinary care in achieving meaningful functional recovery and improving quality of life.