van der Laan L, van Spaendonck K, Horstink M W, Goris R J
Department of Surgery, University Hospital Nijmegen, The Netherlands.
J Pain Symptom Manage. 1999 May;17(5):357-62. doi: 10.1016/s0885-3924(99)00009-3.
Complex regional pain syndrome (CRPS) is a syndrome usually localized in the extremities, mostly occurring after a preceding trauma or operation. Dystonia is present in a minority of CRPS patients, but, when present, leads to severe disability. Various pathological factors have been postulated to present in CRPS-dystonia, such as involvement of the sympathetic system, reorganization of the central nervous system, and psychological distress. In the present study, we investigated the involvement of psychological distress in CRPS-dystonia with the aid of the Symptom Checklist-90 Revised (SCL-90R) questionnaire. The SCL-90R is a multidimensional self-report inventory covering various dimensions of psychological distress. In a population of 1006 CRPS patients, we analyzed the SCL-90R scores of 27 patients with CRPS-dystonia (23 female and 4 male) and compared the scores to sample scores of a control female (n = 577) and a control rehabilitation population (n = 56). Insomnia scored significantly higher in the female CRPS-dystonia population, as compared to the control female population (P < 0.001), and in the total CRPS-dystonia population, as compared to the rehabilitation population (P < 0.01). Remarkable was the significantly higher score of somatization in the rehabilitation population, as compared to the CRPS-dystonia population (P = 0.006). For the other dimensions of psychological distress of the SCL-90R, the scores of the CRPS-dystonia and control populations were similar. With regard to the SCL-90R scores, we conclude that specific psychological profiles are not present in CRPS-dystonia.
复杂性区域疼痛综合征（CRPS）是一种通常局限于四肢的综合征，大多发生在先前的创伤或手术后。少数CRPS患者存在肌张力障碍，一旦出现，会导致严重残疾。多种病理因素被认为与CRPS-肌张力障碍有关，如交感神经系统受累、中枢神经系统重组和心理困扰。在本研究中，我们借助症状自评量表90修订版（SCL-90R）问卷调查了心理困扰在CRPS-肌张力障碍中的作用。SCL-90R是一种涵盖心理困扰各个维度的多维自评量表。在1006名CRPS患者中，我们分析了27例CRPS-肌张力障碍患者（23例女性和4例男性）的SCL-90R评分，并将这些评分与一组对照女性（n = 577）和一组对照康复人群（n = 56）的样本评分进行比较。与对照女性人群相比，女性CRPS-肌张力障碍人群的失眠得分显著更高（P < 0.001）；与康复人群相比，CRPS-肌张力障碍总人群的失眠得分也显著更高（P < 0.01）。值得注意的是，与CRPS-肌张力障碍人群相比，康复人群的躯体化得分显著更高（P = 0.006）。对于SCL-90R心理困扰的其他维度，CRPS-肌张力障碍人群和对照人群的得分相似。关于SCL-90R评分，我们得出结论，CRPS-肌张力障碍不存在特定的心理特征。
