Background:Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the median nerve at the wrist which causes severe symptoms. However, psychological aspects can affect how patient perceive this pain and can cause similar pain in some instances. This study aims to determine the association between symptoms severity, functional status, and nerve conduction studies (NCS) of adult patients with carpal tunnel syndrome (CTS) and their anger, anxiety, and depression status. Methods:This case-control study was conducted in clinics in Damascus, Syria. Controls were frequency matched by gender and age from a general clinic. Interviews based on questionnaires were used that included Boston carpal tunnel questionnaire (BCTQ-A), Hospital Anxiety and Depression Scale (HADS), Dimensions of Anger Reactions Scale-5 (DAR-5) and Nerve Conduction Studies (NCS). Results:Overall, 242 patients (121 cases) were included in this study. Cases with CTS had signi cantly higher anxiety and depression when compared with controls, but not higher anger. Cases with higher anxiety, depression and anger had signi cantly more CTS symptoms and less functional status. Anxiety was also higher in cases with normal NCS in case group. When using regression, anxiety and depression remained signi cantly associated with having CTS. Conclusion:Anxiety and depression are more prominent with CTS. Furthermore, having anxiety and depression were associated with more CTS symptoms in the hand. Having anger was also associated with more CTS symptoms among cases. These ndings emphasise on the importance of psychological aspects when having hand pain or CTS symptoms as these patients might have these symptoms despite having normal NCS.

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Background:Carpal tunnel syndrome (CTS) is a common entrapment neuropathy of the median nerve at the wrist which causes severe symptoms. However, psychological aspects can affect how patient perceive this pain and can cause similar pain in some instances. This study aims to determine the association between symptoms severity, functional status, and nerve conduction studies (NCS) of adult patients with carpal tunnel syndrome (CTS) and their anger, anxiety, and depression status.Methods:This case-control study was conducted in clinics in Damascus, Syria. Controls were frequency matched by gender and age from a general clinic. Interviews based on questionnaires were used that included Boston carpal tunnel questionnaire (BCTQ-A), Hospital Anxiety and Depression Scale (HADS), Dimensions of Anger Reactions Scale-5 (DAR-5) and Nerve Conduction Studies (NCS). Results:Overall, 242 patients (121 cases) were included in this study. Cases with CTS had significantly higher anxiety and depression when compared with controls, but not higher anger. Cases with higher anxiety, depression and anger had significantly more CTS symptoms and less functional status. Anxiety was also higher in cases with normal NCS in case group. When using regression, anxiety and depression remained significantly associated with having CTS.Conclusion:Anxiety and depression are more prominent with CTS. Furthermore, having anxiety and depression were associated with more CTS symptoms in the hand. Having anger was also associated with more CTS symptoms among cases. These findings emphasise on the importance of psychological aspects when having hand pain or CTS symptoms as these patients might have these symptoms despite having normal NCS.

Background and Aims: Carpal tunnel syndrome (CTS) is a median nerve neuropathy that classically causes symptoms along the median nerve distribution. However, extraterritorial symptoms are common and associated with more severe pain. Therefore, assessing the disability caused and its association with psychological distress is crucial. This paper aims to discover the degree of psychological distress, disability, and upper extremity symptoms that CTS patients with extraterritorial symptoms experience and the correlation between disability, psychological distress, and nerve conduction studies (NCS). Methods:This cross-sectional study was conducted in a neurophysiology outpatient clinic. Participants were patients diagnosed with CTS with extraterritorial symptoms. Data were collected during interviews using Quick Disabilities of Arm, Shoulder & Hand (QuickDASH), Hospital Anxiety and Depression Scale (HADS), Dimensions of Anger Reactions scale-5 (DAR-5), and NCS.Results: This study included 171 patients. CTS patients with extraterritorial symptoms demonstrated 44.4% disability with 50.9% severe to extreme pain, borderline abnormal anxiety and depression, and problematic anger. There was a significant positive correlation between disability level and anxiety, depression, and anger (p<0.05). However, no significant correlation between disability and NCS was found (p>0.05). The work-related disability had a significant correlation with anxiety and depression but no correlation with anger. Interpretation: This study opens the door for future studies to test the contribution of psychological factors to the spread of extraterritorial symptoms as a part of other mechanisms discussed by previous studies.

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