STRESSFUL LIFE EVENTS AND PSYCHOLOGICAL DYSFUNCTION IN COMPLEX REGIONAL PAIN SYNDROME TYPE-I

Objective: To determine to what extent stressful life events and psych ological dysfunction play a role in the pathogenesis of Complex Region al Pain Syndrome type I (CRPS). Design: A comparative study between a CRPS group and a control group. Stressful life events and psychologica l dysfunction evaluation was performed with a life event rating list a nd the Symptom Checklist-90 (SCL-90). Setting: A university hospital. Subjects: The CRPS group consisted of 24 patients with a history of up per extremity CRPS of less than 3 months. The control group consisted of 42 hand pathology patients waiting for elective hand surgery within the next 24 hours. Main Outcome Measures: Stressful life event rating was measured using the Social Readjustment Rating Scale. Psychologica l dysfunction was measured using the SCL-90. Results: Stressful life e vents were experienced by 19 patients (79.2%) in the CRPS group and by 9 patients (21.4%) in the control group. This difference was signific ant. Testing of psychological dysfunction (SCL-90) in CRPS patients an d the control group demonstrated some significant differences: male pa tients were more anxious than male controls; female patients were stat istically more depressed, had feelings of inadequacy, and were emotion ally less stable than female controls. In multivariate analysis, no si gnificant differences were found across gender, age, or gender X group interactions. Of the SCL-90 dimensions, only insomnia correlated with the experienced stressful life events. Conclusion: Stressful life eve nts are more common in the CRPS group, which indicates that there may be a multiconditional model of CRPS. The experience of stressful life events besides trauma or surgery are risk factors, not causes, in such a model.