Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation.
Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation.
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DOI：
10.3389/fpsyg.2016.00468
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发表时间：
2016
影响因子：
3.8
通讯作者：
Tamburin S
中科院分区：
文献类型：
--
作者：
Castelnuovo G;Giusti EM;Manzoni GM;Saviola D;Gatti A;Gabrielli S;Lacerenza M;Pietrabissa G;Cattivelli R;Spatola CA;Corti S;Novelli M;Villa V;Cottini A;Lai C;Pagnini F;Castelli L;Tavola M;Torta R;Arreghini M;Zanini L;Brunani A;Capodaglio P;D'Aniello GE;Scarpina F;Brioschi A;Priano L;Mauro A;Riva G;Repetto C;Regalia C;Molinari E;Notaro P;Paolucci S;Sandrini G;Simpson SG;Wiederhold B;Tamburin S
背景：为了向神经系统疾病继发的慢性疼痛患者提供有效的护理，卫生专业人员必须评估心理社会因素在这种疾病的发生和维持中的作用，同时考虑情绪和认知如何影响治疗过程。此外，重要的是不仅要认识到各种情况下常见的对疼痛的心理反应，而且要评估这些综合征在可能涉及的心理因素方面有何不同。由于仍缺乏对这些因素的广泛评估，意大利神经康复疼痛共识会议 (ICCPN) 旨在整理这些主题的现有证据。目的：确定与神经系统疾病继发性疼痛相关或可预测的心理因素，并评估这些方面对神经康复结果的影响。方法：进行了两次审查。首先，对评估心理因素与疼痛之间的关联或这些方面对慢性疼痛的预测价值的研究进行了 PUBMED 检索。然后对纳入的论文的方法学质量进行评级，并提出相应的建议。在第二项研究中，使用相同的方法收集关于心理因素对神经康复中疼痛治疗反应的预测作用的现有证据。结果：第一次文献检索共找到 1170 条结果，最终数据库包含 189 篇文章。研究发现，抑郁、焦虑、疼痛灾难化、应对策略和认知功能等因素与各种情况下的疼痛有关。然而，慢性肌肉骨骼疼痛、偏头痛、神经病变以及与复杂残疾相关的病症在所涉及的心理方面存在差异。第二次 PUBMED 检索产生了 252 项研究，并且全部进行了评估。研究发现，焦虑、抑郁、疼痛灾难化、应对策略和疼痛信念与多学科项目、手术、物理治疗和心理干预的结果有不同程度的相关性。最后，人们发现存在感与虚拟现实作为分散注意力的工具的有效性有关。结论：一些心理因素与神经系统疾病继发的疼痛有关，应该承认和解决，以便有效治疗这种疾病。这些因素还可以预测对神经康复干预的治疗反应。
Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions.