title: Neuropathic pain and psychological morbidity in patients with treated leprosy: a cross-sectional prevalence study in Mumbai.
abstract: BACKGROUND
  Neuropathic pain has been little studied in leprosy. We assessed the prevalence and clinical characteristics of neuropathic pain and the validity of the Douleur Neuropathique 4 questionnaire as a screening tool for neuropathic pain in patients with treated leprosy. The association of neuropathic pain with psychological morbidity was also evaluated.
  
  
  RESULTS
  Adult patients who had completed multi-drug therapy for leprosy were recruited from several Bombay Leprosy Project clinics. Clinical neurological examination, assessment of leprosy affected skin and nerves and pain evaluation were performed for all patients. Patients completed the Douleur Neuropathique 4 and the 12-item General Health Questionnaire to identify neuropathic pain and psychological morbidity.
  
  
  CONCLUSIONS
  One hundred and one patients were recruited, and 22 (21.8%) had neuropathic pain. The main sensory symptoms were numbness (86.4%), tingling (68.2%), hypoesthesia to touch (81.2%) and pinprick (72.7%). Neuropathic pain was associated with nerve enlargement and tenderness, painful skin lesions and with psychological morbidity. The Douleur Neuropathique 4 had a sensitivity of 100% and specificity of 92% in diagnosing neuropathic pain. The Douleur Neuropathique 4 is a simple tool for the screening of neuropathic pain in leprosy patients. Psychological morbidity was detected in 15% of the patients and 41% of the patients with neuropathic pain had psychological morbidity.
authors.affiliation: London School of Hygiene & Tropical Medicine, London, United Kingdom.
authors.forename: Estrella
authors.initials: E
authors.lastname: Lasry-Levy
authors.forename: Aki
authors.initials: A
authors.lastname: Hietaharju
authors.forename: Vivek
authors.initials: V
authors.lastname: Pai
authors.forename: Ramaswamy
authors.initials: R
authors.lastname: Ganapati
authors.forename: Andrew S C
authors.initials: AS
authors.lastname: Rice
authors.forename: Maija
authors.initials: M
authors.lastname: Haanpää
authors.forename: Diana N J
authors.initials: DN
authors.lastname: Lockwood
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007918:Leprosy / Q000150:complications* / Q000188:drug therapy / Q000473:pathology / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis* / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents