Stress, Pain, Sleep, and Neuropsychiatric Disorders (SPLENDID) In Patients of a Workers Compensation System in Chile


  • To characterize stress, chronic pain, sleep disorders, and neuropsychiatric disorders in working adults attending workers compensation hospital system for the following types of injuries: spinal cord, mild brain injury, bone fractures, burns, and soft tissue injuries of various etiologies.
  • To assess the extent to which chronic pain is associated with stress, sleep and neuropsychiatric disorders.
  • To examine the extent to which chronic pain is associated with novel chemical and molecular markers of stress and stress response.


Spinal cord injury, burns, limbs and spinal fractures, soft tissue injuries and mild brain injury are traumatic events that results in disturbances to normal sensory, motor, or autonomic function and ultimately impact a patient’s physical, psychological, and social well-being. While the true incidence of traumatic brain injury (TBI) and concussion is not known, it is estimated to occur in more than 3.5 million people in the United States and 10 million people worldwide annually. Chronic pain, sleep insufficiency, depression and depressive symptoms impede the physical rehabilitation process and exacerbate physical health problems associated with injury. Injury or trauma is also associated with stress response that results in endocrinologic, immunologic, hormonal and metabolic changes.

The effects of work-related stress on ill-health operate in physiological, cognitive, emotional and behavioral ways. Work related stress in addition to the stress response to trauma and chronic pain in an injured worker interferes directly with rehabilitation and contributes to comorbid negative psychosocial and psychiatric outcomes such as depression, fatigue and a vicious circle of pain disorders. There is an accumulating body of epidemiologic evidence showing chronic pain is associated with chemical and molecular markers of stress and stress response. Little is known about the relationship between trauma, pain, work-related stress and neuro psychiatric outcomes in the context of working adults in Chile.

Study Design and Setting

The study will be conducted at Hospital del Trabajador a workers compensation hospital in Santiago, Chile. The Hospital is the referral center for trauma and professional diseases of Asociación Chilena de Seguridad, the biggest workers compensation system in Chile with more than two million affiliated workers. In this study, the following information are collected: (a) interviewer-administered questionnaires are used to obtain information about socio-demographic characteristics, lifestyle characteristics, chronic pain, stress, sleep and symptoms of neuropsychiatric disorders, (b) participants’ resting blood pressure, heart rate and pulse will be measured.  They will be weighed in light clothing, and their neck, waist, hip mid-thigh and mid-arm circumferences will also be measured. Measures of standing height will also be taken, (c) participants’ saliva samples and hair samples will be taken.

Key Study Personnel

Dr. Michelle Williams, Principal Investigator
Dr. Bizu Gelaye, Co-Investigator
Dr. Juan Carlos Velez, Local Investigator
Dr. Lauren Friedman, Project Coordinator