Brinkers Michael, Rumpelt Paulina, Lux Anke, Kretzschmar Moritz, Pfau Giselher
Department of Anaesthesiology and Intensive Care Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.
Department of Diagnostic and Interventional Radiology, Oberlausitz-Kliniken, Bautzen, Germany.
Pain Res Manag. 2018 Oct 17;2018:2894360. doi: 10.1155/2018/2894360. eCollection 2018.
Complex regional pain syndrome (CRPS) is a multifactorial disorder with complex aetiology and pathogenesis. At the outpatient pain clinic of Magdeburg University Hospital, all patients, without exception, are subject to permanent psychiatric care delivered by a consultation-liaison psychiatrist. In CRPS, psychological stabilization and treatment of the neuropathic aspects are equally important. The aim of this single-center retrospective study was to determine mental/psychiatric defects impairing pain processing at the time of investigation and show the effects of treating mental disorders and neuropathic pain with the same psychotropic drugs.
On admission, the consultation-liaison psychiatrist examined the mental state of every patient in a semistructured interview according to AMDP (working group for methods and documentation in psychiatry). Due to the model of the Department of Anaesthesiology, we are able to compare the group of CRPS patients with all other outpatients treated for pain.
The medical treatment of psychiatric dysfunction leads to an analgesic effect. Only every second CRPS patient had an additional psychiatric diagnosis, and 15.6% were diagnosed with depressive mood disorders and show a higher prevalence of depressive symptoms than the general population and exceed the mean for all patients treated in our pain clinic.
In neuropathies, treatment of the neuropathic pain has a modulating effect on mental disorders. As CRPS patients are frequently affected by depressions, and owing to the connection between depression and suicidal tendencies, patients should be seen by a consultation-liaison psychiatrist, and nonpsychiatrists should pay special attention to this patient group.
复杂性区域疼痛综合征（CRPS）是一种病因和发病机制复杂的多因素疾病。在马格德堡大学医院的门诊疼痛诊所，所有患者无一例外都接受由会诊联络精神科医生提供的长期精神护理。在CRPS中，心理稳定和神经病变方面的治疗同样重要。这项单中心回顾性研究的目的是确定在调查时损害疼痛处理的精神/心理缺陷，并展示使用相同精神药物治疗精神障碍和神经性疼痛的效果。
入院时，会诊联络精神科医生根据AMDP（精神病学方法和文件编制工作组）在半结构化访谈中检查每位患者的精神状态。由于麻醉科的模式，我们能够将CRPS患者组与所有其他因疼痛接受治疗的门诊患者进行比较。
精神功能障碍的药物治疗产生镇痛效果。只有每第二位CRPS患者有额外的精神诊断，15.6%被诊断为抑郁情绪障碍，且其抑郁症状的患病率高于一般人群，超过了我们疼痛诊所所有接受治疗患者的平均水平。
在神经病变中，神经性疼痛的治疗对精神障碍有调节作用。由于CRPS患者经常受到抑郁症的影响，且鉴于抑郁症与自杀倾向之间的联系，患者应由会诊联络精神科医生诊治，非精神科医生应特别关注这一患者群体。
