Departments of Psychiatry double daggerHematology daggerDuke Pain and Palliative Care Clinic, Duke University Medical Center, Durham, NC 27705, USA.
Clin J Pain. 2010 Mar-Apr;26(3):258-63. doi: 10.1097/AJP.0b013e3181bff815.
The present paper examines the literature that addresses psychologic aspects involved in complex regional pain syndrome from a historic perspective to provide a rationale for the emergence of psychologic theories to explain its pathogenesis. The support of such perspective is then analyzed through the review of evidence-based studies.
A review of the literature from a historic perspective was presented since its first description to the present time, including the clinical presentation and associated symptoms. An evidence-based approach was used to review the literature on complex regional pain syndrome and psychologic factors associated with the etiology or as predictors in the development of the disorder.
After reviewing the literature on the history and the myths associated with complex regional pain syndrome, a hypothesis is provided based on an analysis of the Zeitgeist in the development of the psychologic theory associated with the disorder. We also concluded there is no evidence to support a linear relationship that establishes a psychologic predisposition to develop the disorder.
An analysis of the Zeitgeist when complex regional pain syndrome was first described helps to understand the long-standing theories associated with a psychological theory of its etiology. This understanding should help to undermine the perpetuation of such claims which may contribute to undertreatment and misdiagnosis. To be consistent with todays Zeitgeist we must incorporate psychologic aspects, which while not causal in nature or exclusive of complex regional pain syndrome, are strongly associated with a wide spectrum of chronic pain disorders.
本文从历史角度审视了涉及复杂区域疼痛综合征心理方面的文献，为解释其发病机制的心理理论的出现提供了依据。然后通过对基于证据的研究的回顾来分析这种观点的支持。
从该疾病的首次描述到现在，包括临床表现和相关症状，对文献进行了历史回顾。采用基于证据的方法对复杂区域疼痛综合征和与病因相关的心理因素或作为该疾病发展预测因素的文献进行了综述。
在回顾了与复杂区域疼痛综合征相关的历史和神话文献之后，根据与该疾病相关的心理理论的时代精神分析提供了一个假设。我们还得出结论，没有证据支持建立心理易感性与发病之间的线性关系。
当首次描述复杂区域疼痛综合征时对时代精神的分析有助于理解与其病因的心理理论相关的长期存在的理论。这种理解应该有助于打破这种说法的持续存在，这种说法可能导致治疗不足和误诊。为了与当今的时代精神保持一致，我们必须将心理方面纳入其中，尽管这些心理方面不是病因或排除复杂区域疼痛综合征，但与广泛的慢性疼痛障碍密切相关。
