The aim of this study was to investigate the role of psychological factors in the development of complex regional pain syndrome (CRPS) type I following the fracture of the distal radius. Fifty patients (average age 57.70 +/- A 13.43 years) with a distal radius fracture were enrolled in the present study. All of the patients were treated by closed reduction and cast immobilization. The Toronto Alexithymia Scale-20, Anxiety Sensitivity Index, State-Trait Anxiety Inventory, and Beck Depression Inventory were used to determine the patients' psychological features 2 days after the fracture. The patients were followed for 2 months after cast immobilization was completed using the International Association for the Study of Pain criteria to diagnose CRPS type I. CRPS type I developed in 13 (26%) patients of the 32 (34.4%) female patients and 18 (11.1%) male patients. The risk of CRPS type I was significantly increased in patients with high trait anxiety scores (P = 0.038). The results show that, after fracturing the distal radius, patients who have an anxious personality have a higher risk of developing CRPS type I. Following these patients closely for the development of CRPS type I may be advantageous for early preventative and therapeutic interventions.