{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:10:37Z","timestamp":1777896637953,"version":"3.51.4"},"reference-count":38,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2018,6,4]],"date-time":"2018-06-04T00:00:00Z","timestamp":1528070400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Sci Law"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to review demographic and clinical characteristics of patients with complex regional pain syndrome type 1 (CRPS) seen in a UK medico-legal setting \u2013 particularly the relationship between CRPS and somatoform disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty consecutive cases of CRPS (interviewed 2005\u20132016) undergoing psychiatric assessment were reviewed. A systematic assessment of mental states was conducted via interview and examination of medical\/psychiatric records. Thirty patients also completed the Brief Illness Perception Questionnaire (BIPQ).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty per cent of patients ( n\u2009=\u200930) were female, and the mean age was 43 years. Twenty-two per cent ( n\u2009=\u200911) were employed, and 60% ( n\u2009=\u200930) received disability benefits. Symptoms were reported in the upper limb (62%; n\u2009=\u200931), lower limb (30%; n\u2009=\u200915), both (6%; n\u2009=\u20093) or elsewhere (2%; n\u2009=\u20091). Eighty-four per cent ( n\u2009=\u200942) satisfied DSM-5 criteria for current somatoform disorder. A history of more than two pain-related functional somatic syndromes (e.g. non-cardiac chest pain) was found in 42% ( n\u2009=\u200921) and functional neurological symptoms (e.g. \u2018claw-hand\u2019) in 42% ( n\u2009=\u200921). BIPQ scores resembled those associated with somatoform disorders and disorders mediated by psychological factors (e.g. irritable bowel syndrome). In 38% ( n\u2009=\u200919), the CRPS diagnosis was disputed among experts. A history of depression was noted in 60% ( n\u2009=\u200930), panic attacks in 20% ( n\u2009=\u200910) and alcohol\/substance misuse in 18% ( n\u2009=\u20099). Opiates were prescribed to 64% ( n\u2009=\u200932).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients diagnosed with CRPS involved in litigation have high rates of prior psychopathology (mainly somatoform disorders) and pain-related disability for which opiate use is common. They risk an adverse reaction to limb pain \u2018shaped\u2019 by maladaptive illness beliefs. The CRPS diagnosis lacks reliability in medico-legal settings and may cause iatrogenic harm<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0025802418779934","type":"journal-article","created":{"date-parts":[[2018,6,5]],"date-time":"2018-06-05T01:25:40Z","timestamp":1528161940000},"page":"147-155","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Complex regional pain syndrome type 1 in the medico-legal setting: High rates of somatoform disorders, opiate use and diagnostic uncertainty"],"prefix":"10.1177","volume":"58","author":[{"given":"Christopher","family":"Bass","sequence":"first","affiliation":[{"name":"Department of Psychological Medicine, John Radcliffe Hospital, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Yates","sequence":"additional","affiliation":[{"name":"The London School of Medicine and Dentistry, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,6,4]]},"reference":[{"key":"bibr1-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h2730"},{"key":"bibr2-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1007\/s00702-011-0601-1"},{"key":"bibr3-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.09.008"},{"key":"bibr4-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2006.00169.x"},{"key":"bibr5-0025802418779934","first-page":"153","volume":"20","author":"Crick B","year":"2011","journal-title":"J Surg Orthop Adv"},{"key":"bibr6-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2016.09.024"},{"key":"bibr7-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000007"},{"key":"bibr8-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000282"},{"key":"bibr9-0025802418779934","doi-asserted-by":"crossref","first-page":"g2631","DOI":"10.1136\/bmj.g2631","volume":"348","author":"Ek J.","year":"2014","journal-title":"Br Med J"},{"key":"bibr10-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1016\/J.JHSB.2006.08.009"},{"key":"bibr11-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31817f4c9d"},{"key":"bibr12-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e31815ca278"},{"key":"bibr13-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1258\/rsmmsl.49.4.241"},{"key":"bibr14-0025802418779934","volume":"28","author":"Campbell A","year":"2014","journal-title":"Law Soc Gazette"},{"key":"bibr15-0025802418779934","first-page":"235","volume":"4","author":"Jenner C.","year":"2017","journal-title":"J Pers Inj Law"},{"key":"bibr16-0025802418779934","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.11-6-596"},{"key":"bibr17-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2013.06.033"},{"key":"bibr18-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1080\/09638280500287320"},{"key":"bibr19-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.44.2.173"},{"key":"bibr20-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2012.09.002"},{"key":"bibr21-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2015.1070851"},{"key":"bibr22-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.05.003"},{"key":"bibr23-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2008.07.002"},{"key":"bibr24-0025802418779934","unstructured":"David Kerr\n                      v\n                      Stiell\n                      [2009] CSOH 67."},{"key":"bibr25-0025802418779934","unstructured":"Alexander Darg\n                      v\n                      Commissioner for the Metropolitan Police\n                      [2009] EWHC 684 (QB)."},{"key":"bibr26-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0404.2000.101004262x.\/"},{"key":"bibr27-0025802418779934","doi-asserted-by":"publisher","DOI":"10.5152\/eurjrheumatol.2014.140061"},{"key":"bibr28-0025802418779934","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12092"},{"key":"bibr29-0025802418779934","doi-asserted-by":"crossref","unstructured":"Lipman M, Hess D, Werner B, et\u00a0al. 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