IS THERE A RELATIONSHIP BETWEEN REFLEX SYMPATHETIC DYSTROPHY AND HELPLESSNESS - CASE-REPORTS AND A HYPOTHESIS

Five case reports that illustrate the possible contribution of psychol ogical factors in the etiopathogenesis of reflex sympathetic dystrophy (RSD) are presented. All five patients at the time of physical trauma were confronted with a significant loss that either accidentally coin cided with the trauma, or was related to the experience of the trauma itself. The patients' reaction to the loss was invariably characterize d by helplessness. A biopsychosocial hypothesis which considers the po ssible role of psychophysiological and behavioral aspects of helplessn ess in the precipitation, maintenance, and/or enhancement of RSD is ou tlined.