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Pain Research and Management
Volume 20, Issue 4, Pages 189-194
Original Article

Psychological Distress and Stressful Life Events in Pediatric Complex Regional Pain Syndrome

Julia Wager,1,2 Hannah Brehmer,2 Gerrit Hirschfeld,3 and Boris Zernikow1,2

1German Paediatric Pain Centre, Children’s and Adolescents’ Hospital Datteln, Witten/Herdecke University, Germany
2Department of Children’s Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine, Germany
3University of Applied Sciences Osnabrück, Germany

Copyright © 2015 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: There is little knowledge regarding the association between psychological factors and complex regional pain syndrome (CRPS) in children. Specifically, it is not known which factors precipitate CRPS and which result from the ongoing painful disease.

OBJECTIVES: To examine symptoms of depression and anxiety as well as the experience of stressful life events in children with CRPS compared with children with chronic primary headaches and functional abdominal pain.

METHODS: A retrospective chart study examined children with CRPS (n=37) who received intensive inpatient pain treatment between 2004 and 2010. They were compared with two control groups (chronic primary headaches and functional abdominal pain; each n=37), who also received intensive inpatient pain treatment. Control groups were matched with the CRPS group with regard to admission date, age and sex. Groups were compared on symptoms of depression and anxiety as well as stressful life events.

RESULTS: Children with CRPS reported lower anxiety and depression scores compared with children with abdominal pain. A higher number of stressful life events before and after the onset of the pain condition was observed for children with CRPS.

CONCLUSIONS: Children with CRPS are not particularly prone to symptoms of anxiety or depression. Importantly, children with CRPS experienced more stressful life events than children with chronic headaches or abdominal pain. Prospective long-term studies are needed to further explore the potential role of stressful life events in the etiology of CRPS.