Nondermatomal somatosensory deficits in chronic pain patients: are they really hysterical?

Egloff, Niklaus; Maecker, Folkert; Stauber, Stefanie; Sabbioni, Marzio E; Tunklova, Libuse; von Känel, Roland (2012). Nondermatomal somatosensory deficits in chronic pain patients: are they really hysterical? Pain, 153(9), pp. 1847-51. Amsterdam: Elsevier 10.1016/j.pain.2012.05.006

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Patients with chronic pain disorders frequently show nondermatomal somatosensory deficits (NDSDs) that are considered to be functional. Typically, NDSDs show quadratomal or hemibody distribution ipsilateral to the areas of chronic pain. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition and the International Classification of Diseases, 10th revision, such functional somatosensory deficits are classified in the chapter "conversion disorder." Many publications also used the term "hysterical sensory loss." However, doubts are increasing about this one-sided psychiatric view. We aimed to better characterize the biopsychosocial factors associated with NDSDs. Therefore, we compared 2 groups of inpatients with chronic pain disorder, of whom 90 suffered from NDSDs and 90 did not. The patients with NDSDs all showed widespread somatosensory deficits with hemibody distribution. On logistic regression analysis, history of a prior physical trauma was positively predictive for patients with NDSDs. Personality disorder and adverse childhood experiences were positively predictive for the control group with chronic pain disorders without NDSDs. The frequencies of comorbid depression and anxiety disorder did not differ statistically between groups. In conclusion, pain patients with NDSDs are, psychopathologically, by no means more noticeable personalities than patients with chronic pain disorder without NDSDs. Similar to complex regional pain syndromes, we assume a multifactorial etiology of NDSDs, including stress. Based on our observations, terms like "hysteric" should not be applied any longer to patients with NDSDs who suffer from chronic pain.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology > Centre of Competence for Psychosomatic Medicine

UniBE Contributor:

Egloff, Niklaus; Maecker, Folkert; Stauber, Stefanie and von Känel, Roland

ISSN:

0304-3959

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:36

Last Modified:

06 Dec 2013 13:36

Publisher DOI:

10.1016/j.pain.2012.05.006

PubMed ID:

22867972

Web of Science ID:

000307299500014

URI:

https://boris.unibe.ch/id/eprint/14684 (FactScience: 221783)

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