Korean J Pain.  2021 Jan;34(1):94-105. 10.3344/kjp.2021.34.1.94.

Role of affective instability on suicidal risk in complex regional pain syndrome: a diary approach (preliminary report)

• Jeong S
• An J
• Cho S

• KMID: 2510316
• DOI: http://doi.org/10.3344/kjp.2021.34.1.94

Abstract

Background
Many patients with complex regional pain syndrome (CRPS) have been known to be at risk of suicide, due to severe pain and its comorbid conditions. The risk of suicide may be associated with affective instability, which is an indicator of emotional dysregulation. Particularly, unstable shifts in negative emotions are difficult to cope with, which may result in individuals feeling uncontrollable, hopeless, and entrapped. This study aimed to examine the role of affective instability in the relationship between pain intensity and suicide risk (suicidal ideation and impulsivity) in patients with CRPS, by employing a daily diary.
Methods
Twenty-three patients registered at the CRPS Association in Korea were asked to complete a day-to-day routine for 15 days, followed by a diary composed of pain intensity, suicidal ideation, impulsivity, and positive and negative affects.
Results
Results showed that the interactions between negative affective instability and daily pain intensity were statistically significant on daily suicidal ideation (coefficient = 0.41, t (21) = 2.56, P < 0.050) and daily impulsiveness (coefficient = 1.20, t (19) = 3.35, P < 0.010). However, those between positive affective instability and daily pain intensity were not.
Conclusions
This study is the first attempt to investigate the role of affective instability on the relationship between daily pain intensity and daily suicide risk in patients with CRPS. Our findings suggest that health professionals pay considerable attention to the instability of negative affects when assessing and managing patients with CRPS at risk of suicide.

Keyword

Affect; Complex Regional Pain Syndromes; Emotions; Impulsive Behavior; Mood Disorders; Pain; Suicidal Ideation; Suicide

Figure

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  Fig. 1 The data collected by the pain diary had multilevel characteristics that were measured daily (level 1) nested in the individual (level 2). Level 1 included the repeated measures (i.e., positive and negative affects, pain intensity, suicidal ideation, and impulsivity), and level 2 included the individual measures (i.e., sex, age, pain duration, pain-related finance support, pain-related court action, pain intensity, depression, suicidal ideation, and impulsivity).

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