Association between treatment-related early changes in psychological factors and development of postherpetic neuralgia

  • Rie Koga
  • Keiko YamadaEmail author
  • Rie Ishikawa
  • Yasuhiko Kubota
  • Keisuke Yamaguchi
  • Masako Iseki
Original Article



To examine the association between catastrophizing and pain intensity with acute herpes zoster, and the association of treatment-related early changes in depressive symptoms, anxiety, and catastrophizing with postherpetic neuralgia (PHN) development, independent of acute pain intensity.


We analyzed 44 outpatient participants with acute herpes zoster who completed a 6-month follow-up. Participants completed a self-reported questionnaire with a Visual Analog Scale (VAS), the Pain Catastrophizing Scale (PCS), and the Hospital Anxiety and Depression Scale (HADS) at first visit, and 3 and 6 months, thereafter. We assessed associations between acute pain intensity and analyzed factors using univariate regression analyses. Univariate and bivariate logistic regression models were constructed to assess associations of variables at the first visit and early changes in psychological factors with PHN development.


Sex, severe skin rash at first visit, PCS, and HADS depression were associated with acute pain intensity {standardized regression coefficient, 0.46 [95% confidence interval (CI) 0.12–0.74], 0.36 (95% CI 0.07–0.65), 0.33 (95% CI 0.03–0.62), 0.47 (95% CI 0.19–0.74), respectively}. Acute pain intensity and early change in pain intensity were associated with PHN development [odds ratio (OR) 1.08 (95% CI 1.02–1.14) OR 2.38 (95% CI 1.10–5.16), respectively]. Decreased PCS was associated with decreased risk of PHN development, independent of acute pain intensity [OR 0.31 (95% CI: 0.12–0.80)].


Catastrophizing was associated with acute pain intensity, and lower pain-related catastrophizing among patients with acute herpes zoster was associated with less risk of PHN development, independent of acute pain intensity.


Catastrophizing Herpes zoster Pain Postherpetic neuralgia Psychosocial risk factors 



We thank Benjamin Knight, MSc, and Jane Charbonneau, DVM, from Edanz Group ( for editing drafts of this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare no conflicts of interest in this work.

Supplementary material

540_2019_2679_MOESM1_ESM.docx (27 kb)
Supplementary file1 (DOCX 27 kb)
540_2019_2679_MOESM2_ESM.docx (26 kb)
Supplementary file2 (DOCX 25 kb)


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Copyright information

© Japanese Society of Anesthesiologists 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain MedicineJuntendo University Faculty of MedicineTokyoJapan
  2. 2.Department of Anesthesiology and Pain MedicineSada HospitalFukuokaJapan
  3. 3.Department of PsychologyMcGill UniversityMontrealCanada
  4. 4.Department of Anesthesiology and Pain MedicineHachinohe Heiwa HospitalHachinoheJapan
  5. 5.Osaka Center for Cancer and Cardiovascular Diseases PreventionOsakaJapan
  6. 6.Department of Anesthesiology and Pain ClinicJuntendo Tokyo Koto Geriatric Medical CenterTokyoJapan

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