Abstract
BackgroundThe relationship between physical and psychopathological features in complex regional pain syndrome (CRPS) has been a subject of constant interest, but no data are available in adolescents. Therefore, we aimed to identify the factors associated with psychopathology in adolescents with CRPS ahead of military service.MethodsWe retrospectively reviewed all conscription examinees who had completed a Military Personality Inventory (MPI) during a period between February 2013 and December 2016. A total of 63 persons with a history of CRPS (19-years of age for all) were enrolled. Basic demographic and pain-related data were analyzed to examine their association with MPI results. The mean FGR score as well as the 8 subdomain scores were compared between those with pain duration at < 15 months (n = 30) versus ≥15 months (n = 33). Binary MPI results (normal-abnormal) were also compared between the two groups.ResultsIn multivariate analysis, abnormal MPI was associated with pain duration, with an odds ratio (OR) at 1.05 for every 1-month increase (95% confidence interval (CI) 1.02–1.08; P = 0.002). Subjects with pain duration at ≥15 months have lower faking good response score (P < 0.001 vs. those with pain duration at < 15 months), and higher abnormal MPI result rate, faking bad response, inconsistency, anxiety, depression, somatization, paranoid, personality disorder cluster A, and personality disorder cluster B scores (P < 0.05). Pain duration was significantly associated with the MPI variables.ConclusionsPain duration is associated with psychopathology in adolescents with CRPS. Psychopathologic features increased as the disease duration increased. A comprehensive understanding of time-dependent psychopathological factors could support the planning of multimodal approaches for managing adolescent CRPS.
Highlights
The relationship between physical and psychopathological features in complex regional pain syndrome (CRPS) has been a subject of constant interest, but no data are available in adolescents
We excluded seven conscripts who had a medical history of other psychiatric disorders before the diagnosis of CRPS and two conscripts whose pain symptoms did not correspond with the International Association for the Study of Pain (IASP) Budapest Criteria for CRPS according to the findings of physical examination
The results of the present study were consistent with previous studies in which the frequencies of anxiety, depression, and personality disorders were high among patients with chronic CRPS [27, 28]
Summary
The relationship between physical and psychopathological features in complex regional pain syndrome (CRPS) has been a subject of constant interest, but no data are available in adolescents. Complex regional pain syndrome (CRPS) is a severe pain disorder that affects one or more extremities and typically develops after a trauma or nerve lesions. It is clinically characterized by sensory, autonomic, motor, and trophic symptoms. Researchers and clinicians agree on the reciprocal relationship between the physical and psychological components of pain [5] It has been continuously debated whether these symptoms are the result or the cause of this debilitating disease, it is clear that CRPS is associated with psychological sequelae, such as depression, anxiety, poor quality of life, and functional disabilities [5, 6]. Previous studies have only focused on the presence of CRPS and psychopathology but have not separately investigated the painrelated factors and the demographic (and other) factors that potentially affect psychopathology
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