title: Psychosocial risk factors for postherpetic neuralgia: a prospective study of patients with herpes zoster.
abstract: The results of previous studies using retrospective methods or small samples have suggested that there may be psychosocial risk factors for postherpetic neuralgia (PHN). We conducted a prospective study in which 110 patients with herpes zoster were assessed within the first month after rash onset with measures of acute pain and five broad domains of psychosocial functioning-physical, role, social, and emotional functioning, and stress and social support. Twenty of the 102 patients with follow-up data were diagnosed with PHN, defined as pain that had persisted for 4 months after rash onset. Measures of role functioning, personality disorder symptoms, and disease conviction during herpes zoster each made independent contributions to predicting either presence or intensity of PHN in logistic and linear regression analyses that controlled for relevant demographic and clinical variables, including age and acute pain intensity. These findings indicate that psychosocial variables are risk factors for the development of PHN.
  
  
  CONCLUSIONS
  The results of this prospective study of patients with herpes zoster suggest that future research on the mechanisms and prevention of PHN should consider psychosocial as well as neurobiologic processes.
authors.affiliation: Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Katz
authors.forename: Michael P
authors.initials: MP
authors.lastname: McDermott
authors.forename: Edith M
authors.initials: EM
authors.lastname: Cooper
authors.forename: Robert R
authors.initials: RR
authors.lastname: Walther
authors.forename: Eugene W
authors.initials: EW
authors.lastname: Sweeney
authors.forename: Robert H
authors.initials: RH
authors.lastname: Dworkin
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease / Q000453:epidemiology / Q000523:psychology; D000223:Adaptation, Psychological; D000342:Affective Symptoms / Q000453:epidemiology / Q000523:psychology; D000368:Aged; D005260:Female; D006562:Herpes Zoster / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology*; D010525:Peripheral Nerves / Q000503:physiopathology* / Q000821:virology; D011446:Prospective Studies; D011584:Psychology; D012044:Regression Analysis; D012307:Risk Factors; D012803:Sick Role; D012944:Social Support; D013315:Stress, Psychological / Q000453:epidemiology