Association of Neglect-Like Symptoms with Anxiety, Somatization, and Depersonalization in Complex Regional Pain Syndrome.
Many patients with complex regional pain syndrome (CRPS) report some foreignness of the affected limb, which is referred to as "neglect-like symptoms" (NLS). Despite similarities of the NLS reports to symptoms of body image disturbances in mental disorders, no study has been conducted to examine such associations.



We investigated 50 patients with CRPS and 45 pain control patients (N = 27, chronic limb pain; N = 18, migraine headache). NLS, anxiety, depression, depersonalization, and somatization were assessed using validated questionnaires.



Seventy-two percent of the CRPS patients reported at least one NLS vs 29.6% and 33.3% in the two patient control groups. In limb pain controls, NLS correlated with pain intensity. In CRPS patients, NLS correlated with anxiety (rho = 0.658, P  < 0.001), somatization (rho = 0.616, P  < 0.001), depersonalization (rho = 0.634, P  < 0.001), and pain catastrophizing (rho = 0.456, P  < 0.01), but not with intensity of pain, duration of pain, or pain disability.



In CRPS patients, NLS could be a result of somatization, depression, anxiety, and depersonalization, but probably not of pain. Whether these associations are causative must be clarified in longitudinal psychological studies.
Departments of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.
Matthias
M
Michal
Departments of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.
Julia
J
Adler
Departments of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.
Iris
I
Reiner
Departments of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.
Andreas
A
Wermke
Neurology, University Medical Center Mainz, Mainz, Germany.
Tatiana
T
Ackermann
Neurology, University Medical Center Mainz, Mainz, Germany.
Tanja
T
Schlereth
Neurology, University Medical Center Mainz, Mainz, Germany.
Frank
F
Birklein
D001007:Anxiety / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D057215:Body Dysmorphic Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D058443:Catastrophization; D015984:Causality; D015897:Comorbidity; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003861:Depersonalization / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010468:Perceptual Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors; D013001:Somatoform Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology
CRPS; Pain Disorder; Psychology; Neglect