Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

被引：69

作者：

Castelnuovo, Gianluca ^{[1
,2
]}

Giusti, Emanuele M. ^{[2
]}

Manzoni, Gian Mauro ^{[1
,3
]}

Saviola, Donatella ^{[4
]}

Gatti, Arianna

Gabrieli, Samantha ^{[5
]}

Lacerenza, Marco ^{[5
]}

Pietrabissa, Giada ^{[1
,2
]}

Cattivelli, Roberto ^{[1
]}

Spatola, Chiara A. M. ^{[1
,2
]}

Corti, Stefania ^{[1
]}

Novelli, Margherita ^{[1
]}

Villa, Valentina ^{[1
]}

Cottini, Andrea ^{[6
]}

Lai, Carlo ^{[7
]}

Pagnini, Francesco ^{[2
,8
]}

Castelli, Lorys ^{[9
]}

Tavola, Mario ^{[10
]}

Torta, Riccardo ^{[11
]}

Arreghini, Marco ^{[12
]}

Zanini, Loredana ^{[12
]}

Brunani, Amelia ^{[12
]}

Capodaglio, Paolo ^{[12
]}

D'Aniello, Guido E. ^{[1
]}

Scarpina, Federica ^{[1
,11
]}

Brioschi, Andrea ^{[13
]}

Priano, Lorenzo ^{[11
,13
]}

Mauro, Alessandro ^{[11
,13
]}

Riva, Giuseppe ^{[1
,2
]}

Repetto, Claudia ^{[2
]}

Regalia, Camillo ^{[2
]}

Molinari, Enrico ^{[1
,2
]}

Notaro, Paolo ^{[14
]}

Paolucci, Stefano ^{[15
]}

Sandrini, Giorgio ^{[16
]}

Simpson, Susan G. ^{[17
]}

Wiederhold, Brenda ^{[18
]}

Tamburin, Stefano ^{[19
]}

机构：

[1] San Giuseppe Hosp, Ist Auxol Italiano IRCCS, Psychol Res Lab, Verbania, Italy

[2] Catholic Univ Milan, Dept Psychol, Milan, Italy

[3] eCampus Univ, Fac Psychol, Novedrate, Como, Italy

[4] Santo Stefano Rehabil Ist, Cardinal Ferrari Rehabil Ctr, Fontanellato, Italy

[5] HUMANITAS, Casa Cura San Pio X Sri, Milan, Italy

[6] IRCCS Galeazzi Orthoped Inst, Milan, Italy

[7] Sapienza Univ Rome, Dept Dynam & Clin Psychol, Rome, Italy

[8] Harvard Univ, Dept Psychol, Cambridge, MA 02138 USA

[9] Univ Turin, Dept Psychol, Turin, Italy

[10] Villa Scassi Hosp, Genoa, Italy

[11] Univ Turin, Dept Neurosci Rita Levi Montalcini, Turin, Italy

[12] San Giuseppe Hosp, Ist Auxol Italiano IRCCS, Rehabil Unit, Verbania, Italy

[13] San Giuseppe Hosp, Ist Auxol Italiano IRCCS, Dept Neurol & Neurorehabil, Verbania, Italy

[14] ASST Grande Osped Metropolitano Niguarda, Dept Surg, Pain Ctr Level 2, Milan, Italy

[15] Fdn Santa Lucia IRCCS, Rome, Italy

[16] Univ Pavia, C Mondino Natl Neurol Inst, Dept Brain & Behav Sci, Via Palestro 3, I-27100 Pavia, Italy

[17] Univ S Australia, Sch Psychol Social Work & Social Policy, Adelaide, SA 5001, Australia

[18] Virtual Real Med Inst, Brussels, Belgium

[19] Univ Verona, Dept Neurol & Movement Sci, I-37100 Verona, Italy

来源：

FRONTIERS IN PSYCHOLOGY | 2016年 / 7卷

关键词：

psychological treatments; psychotherapy; neurological rehabilitation; chronic pain; pain; clinical psychology; health psychology; COGNITIVE-BEHAVIORAL THERAPY; LOW-BACK-PAIN; PHANTOM LIMB PAIN; COMPLEX REGIONAL PAIN; RANDOMIZED CONTROLLED-TRIAL; GRADED MOTOR IMAGERY; BIOFEEDBACK-ASSISTED RELAXATION; RECURRENT ABDOMINAL-PAIN; RHEUMATOID-ARTHRITIS; VIRTUAL-REALITY;

D O I：

10.3389/fpsyg.2016.00115

中图分类号：

B84 [心理学];

学科分类号：

04 ; 0402 ;

摘要：

Background: It is increasingly recognized that treating pain is crucial for effective care within neurological rehabilitation in the setting of the neurological rehabilitation. The Italian Consensus Conference on Pain in Neurorehabilitation was constituted with the purpose identifying best practices for us in this context. Along with drug therapies and physical interventions, psychological treatments have been proven to be some of the most valuable tools that can be used within a multidisciplinary approach for fostering a reduction in pain intensity. However, there is a need to elucidate what forms of psychotherapy could be effectively matched with the specific pathologies that are typically addressed by neurorehabilitation teams. Objectives: To extensively assess the available evidence which supports the use of psychological therapies for pain reduction in neurological diseases. Methods: A systematic review of the studies evaluating the effect of psychotherapies on pain intensity in neurological disorders was performed through an electronic search using PUBMED, EMBASE, and the Cochrane Database of Systematic Reviews. Based on the level of evidence of the included studies, recommendations were outlined separately for the different conditions. Results: The literature search yielded 2352 results and the final database included 400 articles. The overall strength of the recommendations was medium/low. The different forms of psychological interventions, including Cognitive Behavioral Therapy, cognitive or behavioral techniques, Mindfulness, hypnosis, Acceptance and Commitment Therapy (ACT), Brief Interpersonal Therapy, virtual reality interventions, various forms of biofeedback and mirror therapy were found to be effective for pain reduction in pathologies such as musculoskeletal pain, fibromyalgia, Complex Regional Pain Syndrome, Central Post Stroke pain, Phantom Limb Pain, pain secondary to Spinal Cord Injury, multiple sclerosis and other debilitating syndromes, diabetic neuropathy, Medically Unexplained Symptoms, migraine and headache. Conclusions: Psychological interventions and psychotherapies are safe and effective treatments that can be used within an integrated approach for patients undergoing neurological rehabilitation for pain. The different interventions can be specifically selected depending on the disease being treated. A table of evidence and recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation is also provided in the final part of the paper.

引用

页数：17

共 260 条

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