Emotional impairment and stressful life events in the etiology of pediatric Complex Regional Pain Syndrome (CRPS)

Background: In children, there is little knowledge regarding the association between psychological factors and CRPS. Specifically, it is not known which factors precipitate CRPS or which ones result from the ongoing painful disease. Objectives: The present study examined symptoms of depression and anxiety as well as the experience of stressful life events in children with CRPS compared to 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 to 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 regarding 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 to children with abdominal pain. A higher number of stressful life events before and after the onset of the pain condition was recorded 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.