title: Complex regional pain syndrome, alexithymia, and psychological distress.
abstract: OBJECTIVE
  This study aims to elucidate the relationships between alexithymia, psychological distress, and pain in persons with complex regional pain syndrome (CRPS).
  
  
  METHODS
  Participants were 60 Israeli adults ages 19-65. This is a cross sectional study with a comparison group. Alexithymia, psychological distress, and pain were assessed in 30 individuals with CRPS in comparison to 30 gender- and age-matched persons with lower back pain (LBP). Assessments included the Toronto Alexithymia Scale, Hospital Anxiety and Depression Scale, and two subscales of the McGill Pain Questionnaire.
  
  
  RESULTS
  Persons with CRPS had significantly higher ratings of psychological distress and of alexithymia when compared to LBP controls. Pain severity was significantly associated with higher levels of alexithymia and psychological distress among persons with CRPS, but not among controls. Alexithymia and pain severity correlations were significantly different between the two groups. In persons with CRPS, the relationships between alexithymia and pain severity and between difficulty identifying feelings and pain were not confounded by psychological distress.
  
  
  CONCLUSIONS
  To our knowledge, this is the first cross sectional study providing empirical evidence on the relationship between alexithymia and CRPS. From the perspective of conceptualizing alexithymia as an outcome of CRPS, findings highlight the importance of early CRPS diagnosis and support the provision of care that addresses pain-related psychological distress and alexithymia among CRPS patients. Also, findings underscore the need to generate alternative, non-physical avenues, such as learning to identify feelings for processing pain, in order to reduce pain among persons with CRPS.
authors.affiliation: Department of Behavioral Sciences, Ariel University, Israel.
authors.forename: Daniella
authors.initials: D
authors.lastname: Margalit
authors.affiliation: Department of Behavioral Sciences, Ariel University, Israel; Reuth Rehabilitation Hospital, Tel Aviv, Israel. Electronic address: laurabenhar@gmail.com.
authors.forename: Laura
authors.initials: L
authors.lastname: Ben Har
authors.affiliation: Institute for Pain Medicine, Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Silviu
authors.initials: S
authors.lastname: Brill
authors.affiliation: Reuth Rehabilitation Hospital, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Vatine
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000209:etiology*; D001364:Awareness; D020918:Complex Regional Pain Syndromes / Q000523:psychology*; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications / Q000209:etiology*
keywords: Alexithymia; CRPS; Complex regional pain syndrome; Pain; Psychological distress; Reflex sympathetic dystrophy