• Matthias Michal, Julia Adler, Iris Reiner, Andreas Wermke, Tatiana Ackermann, Tanja Schlereth, and Frank Birklein.
• Departments of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.
• Pain Med. 2017 Apr 1; 18 (4): 764-772.

BackgroundMany patients with complex regional pain syndrome (CRPS) report some foreignness of the affected limb, which is referred to as "neglect-like symptoms" (NLS). Despite similarities of the NLS reports to symptoms of body image disturbances in mental disorders, no study has been conducted to examine such associations.MethodsWe investigated 50 patients with CRPS and 45 pain control patients (N = 27, chronic limb pain; N = 18, migraine headache). NLS, anxiety, depression, depersonalization, and somatization were assessed using validated questionnaires.ResultsSeventy-two percent of the CRPS patients reported at least one NLS vs 29.6% and 33.3% in the two patient control groups. In limb pain controls, NLS correlated with pain intensity. In CRPS patients, NLS correlated with anxiety (rho = 0.658, P  < 0.001), somatization (rho = 0.616, P  < 0.001), depersonalization (rho = 0.634, P  < 0.001), and pain catastrophizing (rho = 0.456, P  < 0.01), but not with intensity of pain, duration of pain, or pain disability.ConclusionsIn CRPS patients, NLS could be a result of somatization, depression, anxiety, and depersonalization, but probably not of pain. Whether these associations are causative must be clarified in longitudinal psychological studies.© 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

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