A chronic state of illness or pain is often associated with reactive depression and anxiety as well as higher scores on many of the MMPI subscales. Additionally, among adolescents and children with CRPS, the risks of somatization, anxiety, and depression are high, and the duration of pain and depression has been shown to be associated with suicidal ideation. The results of the present study were consistent with previous studies in which the frequencies of anxiety, depression, and personality disorders were high among patients with chronic CRPS. We speculated that demographic characteristics, pain intensity, pain duration, clinical manifestations, and treatment modality invasiveness are associated with the psychopathology of adolescent CRPS. However, we failed to find associations between the psychopathology of adolescents with CRPS with demographic characteristics, the number of items in the IASP criteria, pain intensity, type of CRPS, the site of morbidity, or treatment modalities. Pain duration was the only factor that was significantly associated with psychopathology in our study. Previous studies indicated that pain intensity is associated with psychopathology among patients with chronic pain. Such associations have also been observed among adult CRPS patients. We speculated that pain intensity would be associated with psychopathology in adolescent CRPS, but did not find evidence to support such an association. According to previous research by Logan et al., children and adolescents from 7 to 18 years of age with CRPS had higher pain intensity ratings than other chronic pain groups. However, anxiety and depression were within the normal range in the CRPS group and did not differ from other chronic pain groups. The pain duration among CRPS patients included in their study was 13.00 ± 2.9 months. The fact that anxiety and depression did not differ from normative comparison data may be attributed to the relatively short pain duration. Mesaroli et al. retrospectively reviewed the charts of 59 CRPS patients with a mean age of 13.2 ± 2.6 years. The mean symptom duration was 35.7 ± 43.8 weeks. Their investigation using self-report questionnaires showed that anxiety, depression, and somatization were within normal ranges relative to age- and sex-matched peers. However, through clinical diagnostic interviews, 39% of patients were diagnosed as having anxiety disorders, 12% had depressive disorders, 13% had somatic symptom disorders, and 37% had some type of past adverse events. There was a difference between the self-reporting and clinical interview methods. The onset age of CRPS symptoms among our subjects ranged from 13 to 19 years, and the mean pain duration was 27.41 ± 2.67 months. The age and pain duration of the participants in the current study differed from that in previous studies by Logan et al. and Mesaroli et al., but the key results are generally consistent. As our study and both of these studies had retrospective designs, well-designed prospective studies are warranted. Adolescent and pediatric CRPS have been associated with unique gender ratios. CRPS is approximately 3 to 6 times more common among girls than boys. The study sample investigated by Mesaroli et al. was also predominantly composed of females (74.6%), and as previously mentioned, psychopathologic features were detected via clinical diagnostic interviews. Conversely, our study only included male subjects. Nonetheless, it is worth noting that the two previous studies had similar findings and that these results suggest that adolescent CRPS can manifest with psychopathology regardless of gender. The stress process occurs as a bidirectional communication between the brain and the autonomic nervous system, the cardiovascular system, and the immune system through the neurological and endocrinological mechanisms responsible for cognition, perception, and behavior. In “stressful” conditions, such as the experience of chronic pain, stress-related structural and functional plasticity can occur in corticolimbic structures, such as the hippocampus, amygdala, and the prefrontal cortex. Recent studies have frequently reported that central neuroplasticity also progresses in CRPS. Central neuroplasticity may occur as a form of change in gray matter or alterations in functional and white matter connectivity between brain regions. These processes occur through mechanisms such as the unmasking or strengthening of silent or ineffective synapses, collateral sprouting, and the loss of gamma-aminobutyric acid (GABA) inhibition. Several studies have suggested that gray matter volume is reduced in the insular cortex, nucleus accumbens, and prefrontal cortex of CRPS patients. Additionally, gray matter volume decreases with disease prolongation and progression, corresponding with structural and functional changes in the brain over time in CRPS. Interestingly, previous studies have shown a reverse change, with increased gray matter volume and enhanced functional and structural connectivity after early treatment in pediatric and adolescent CRPS. However, a study by Linnman et al. revealed that pain-induced alterations of functional connectivity in the brain could persist even in a recovered state after functional recovery. Maladaptation of this plasticity can lead to the continuation and worsening of pain and is associated with psychopathology. Early diagnosis and treatment are known to be the major factors associated with successful outcomes for adolescent CRPS patients. Active suspicion of adolescent CRPS and appropriate therapeutic interventions should be enacted promptly after diagnosis due to the potentially harmful effects of CRPS on adolescent development and future health. This will improve the quality of life by reducing pain and by reducing psychopathology by potentially shortening the pain duration. Therefore, there is a need to approach adolescent CRPS with a more time-limited concept when planning the treatment of patients in clinical practice. Korea has a military draft policy. In young soldiers, delays in the diagnosis and treatment of trauma-associated pain that may occur in the military are likely to lead to CRPS. The newly developed psychopathology of soldiers can cause various problems, such as self-harm and harm to fellow soldiers. Therefore, the possibility of psychopathology is especially important for soldiers with chronic pain. However, psychological screening and treatment in the military remain insufficient compared with clinical practice outside the military. Within the military as well, the diagnosis and treatment of CRPS would have to be carried out thoroughly in a more time-limited concept. Psychological evaluations should be conducted to soldiers at appropriate intervals considering psychopathology that can change over time and treatment has to be followed even after the termination of pain. A multidisciplinary approach comprising psychological treatment should be initiated promptly when symptoms persist or worsen. Additionally, special attention should be paid when the soldier’s pain lasts longer than 15 months according to our result. In particular, it is worthwhile to consider early discharge as necessary after re-evaluation of psychopathology during the service period in the case of mandatory military service. This study has several limitations. First, the present study was a retrospective cohort analysis based on self-reported assessments. Considering the difference between self-reported assessments and clinical presentations, the use of self-reported assessments in our study could have introduced some bias, although the reliability and validity of the MPI have been evaluated extensively. Second, because all of the participants were approximately the same age (19 years old) and were all males, caution should be exercised when generalizing the results to the general public, and the possibility of an association between a young age of onset and a distinctive psychopathological pattern cannot be overlooked. The third limitation is the use of an unvalidated modified version of the CSS. Last, psychopathology can be affected by the pain but also it can affect the pain experience vice versa. However, due to the nature of our data, we could not separately reveal the effect of the psychological characteristics on the experience of pain.