title: Stressful life events and psychological dysfunction in Complex Regional Pain Syndrome type I.
abstract: OBJECTIVE
  To determine to what extent stressful life events and psychological dysfunction play a role in the pathogenesis of Complex Regional Pain Syndrome type I (CRPS).
  
  
  METHODS
  A comparative study between a CRPS group and a control group. Stressful life events and psychological dysfunction evaluation was performed with a life event rating list and the Symptom Checklist-90 (SCL-90).
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  The CRPS group consisted of 24 patients with a history of upper extremity CRPS of less than 3 months. The control group consisted of 42 hand pathology patients waiting for elective hand surgery within the next 24 hours.
  
  
  METHODS
  Stressful life event rating was measured using the Social Readjustment Rating Scale. Psychological dysfunction was measured using the SCL-90.
  
  
  RESULTS
  Stressful life events were experienced by 19 patients (79.2%) in the CRPS group and by 9 patients (21.4%) in the control group. This difference was significant. Testing of psychological dysfunction (SCL-90) in CRPS patients and the control group demonstrated some significant differences: male patients were more anxious than male controls; female patients were statistically more depressed, had feelings of inadequacy, and were emotionally less stable than female controls. In multivariate analysis, no significant differences were found across gender, age, or gender x group interactions. Of the SCL-90 dimensions, only insomnia correlated with the experienced stressful life events.
  
  
  CONCLUSIONS
  Stressful life events are more common in the CRPS group, which indicates that there may be a multiconditional model of CRPS. The experience of stressful life events besides trauma or surgery are risk factors, not causes, in such a model.
authors.affiliation: Department of Rehabilitation, University Hospital, Groningen, The Netherlands.
authors.forename: J H
authors.initials: JH
authors.lastname: Geertzen
authors.forename: A T
authors.initials: AT
authors.lastname: de Bruijn-Kofman
authors.forename: H P
authors.initials: HP
authors.lastname: de Bruijn
authors.forename: H B
authors.initials: HB
authors.lastname: van de Wiel
authors.forename: P U
authors.initials: PU
authors.lastname: Dijkstra
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D012019:Reflex Sympathetic Dystrophy / Q000517:prevention & control*; D013315:Stress, Psychological / Q000523:psychology*