BackgroundComplex Regional Pain Syndrome (CRPS) is a clinical syndrome composed of chronic pain, motor impairment, and autonomic dysfunction, usually affecting a limb. Although CRPS seems to be a peripheral disorder, it is accompanied by parietal alterations leading to body schema impairments (the online representations of the body). Impairments to body structural description (the topographical bodily map) were not assessed systematically in CRPS. A patient we encountered with severe disruption to her bodily structural description led us to study this domain further.AimsTo document aberrant body structural description in subjects with CRPS using an object assembly task.MethodsBody Schema Study: 6 subjects with CRPS-I and six age and sex-matched healthy controls completed visual puzzles taken from WAIS-III and WAIS-R. The puzzles were either related to the human body or non-human body objects. Mann–Whitney U-tests were performed to compare groups’ performances.ResultsThe CRPS group received relatively lower scores compared to controls for human body objects (u = 3, p < 0.05), whereas the non-human object scoring did not reveal significant differences between groups (u = 9, p > 0.05).ConclusionCRPS subjects suffer from impaired body structural description, taking the form of body parts disassembly and body parts discontinuity. This impairment can serve as a nidus for aberrant psychological representation of the body.

Background: Many languages use spatial metaphors to describe affective states such as an upward bias to denote positive mood, a downward bias to denote negative mood, a body proximity bias to denote personal relatedness concern, and a right-left bias to denote negative or positive valence. These biases might be related to experiential traces related to these affective states. If this is the case, depressed subjects would show either a downward spatial bias, a body proximity bias, or a right-left shift in attention. We evaluated the occurrence of such biases in subjects with depression compared to healthy controls.Methods: Subjects: 10 subjects with depression (5F:5M; age = 47.2 ± 15.2) and 10 healthy controls (5F:5M; age = 45.8 ± 14.5). Experimental task: line bisection task. Lines were presented in three spatial orientations [vertical (up-down), horizontal (right-left), radial (proximal-distal)] and were either blank, composed with words (negative/positive/neutral), or with smileys (negative/positive/neutral). There were 21 line types, and each was presented eight times, reaching a total of 168 lines.Results: Compared with healthy controls, subjects with depression bisected radial lines significantly closer to their body. There were no significant differences for either horizontal or vertical lines.Conclusion: The proximity spatial bias observed in subjects with depression suggests that depression might activate neural spatial networks. We argue that these networks could be dynamically activated through narcissistic mechanisms as implied in “Mourning and Melancholia” where Freud postulates a narcissistic mediated bias in depression according to which the depressed subjects withdraw from the outside world.