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

Gianluca Castelnuovo, Emanuele Maria Giusti, Gian Mauro Manzoni, Donatella Saviola, Arianna Gatti, Samantha Gabrielli, Marco Lacerenza, Giada Pietrabissa, Roberto Cattivelli, Chiara A. Spatola, Stefania Paola Corti, Margherita Novelli, Valentina Villa, Andrea Cottini, Carlo Lai, Francesco Pagnini, Lorys Castelli, M. Tavola, Riccardo Torta, M. ArreghiniLoredana Zanini, Amelia Brunani, Paolo Capodaglio, Guido E. D'Aniello, Federica Scarpina, Andrea Brioschi, Lorenzo Priano, Alessandro Mauro, Giuseppe Riva, Claudia Repetto, Camillo Regalia, Enrico Molinari, P. Notaro, Stefano Paolucci, Giorgio Sandrini, Susan Simpson, Brenda K. Wiederhold, Stefano Tamburin, Michela Agostini, Enrico Alfonsi, Anna Maria Aloisi, Elena Alvisi, Irene Giovanna Aprile, Michela Armando, Micol Avenali, Eva Azicnuda, Francesco Barale, Michelangelo Bartolo, Roberto Bergamaschi, Mariangela Berlangieri, Vanna Berlincioni, Laura Berliocchi, Eliana Berra, Giulia Berto, Silvia Bonadiman, Sara Bonazza, Federica Bressi, Annalisa Brugnera, Stefano Brunelli, Maria Gabriella Buzzi, Carlo Cacciatori, Andrea Calvo, Cristina Cantarella, Augusto Tommaso Caraceni, Roberto Carone, Elena Carraro, Roberto Casale, Paola Castellazzi, Adele Castino, Rosanna Cerbo, Adriano Chiò, Cristina Ciotti, Carlo Cisari, Daniele Coraci, Elena Dalla Toffola, Giovanni Defazio, Roberto De Icco, Ubaldo Del Carro, Andrea Dell'Isola, Antonio De Tanti, Mariagrazia D'Ippolito, E. Fazzi, Adriano Ferrari, Sergio Ferrari, Francesco Ferraro, Fabio Formaglio, Rita Formisano, Simone Franzoni, Francesca Gajofatto, Marialuisa Gandolfi, Barbara Gardella, Pierangelo Geppetti, Alessandro Giammò, Raffaele Gimigliano, Elena Greco, Valentina Ieraci, Marco Invernizzi, Marco Jacopetti, Silvia La Cesa, Davide Lobba, Francesca Magrinelli, S. Mandrini, Umberto Manera, Paolo Marchettini, Enrico Marchioni, Sara Mariotto, Andrea Martinuzzi, Marella Masciullo, Susanna Mezzarobba, Danilo Miotti, Angela Modenese, Marco Molinari, Salvatore Monaco, Giovanni Morone, Rossella Nappi, Stefano Negrini, Andrea Pace, Luca Padua, Emanuela Pagliano, Valerio Palmerini, Costanza Pazzaglia, Cristiano Pecchioli, Alessandro Picelli, Carlo A. Porro, Daniele Porru, Marcello Romano, Laura Roncari, Riccardo Rosa, Marsilio Saccavini, Paola Sacerdote, Angelo Schenone, Vittorio Schweiger, Giorgio Scivoletto, N. Smania, Claudio Solaro, Vincenza Spallone, Isabella Springhetti, Cristina Tassorelli, Michele Tinazzi, Rossella Togni, Monica Torre, Marco Traballesi, Marco Tramontano, A. Truini, Valeria Tugnoli, Andrea Turolla, Gabriella Vallies, Elisabetta Verzini, Mario Vottero, Paolo Zerbinati

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article number00468
JournalFrontiers in Psychology
Volume7
Issue numberAPR
DOIs
Publication statusPublished - 2016

Keywords

  • Chronic pain
  • Clinical psychology
  • Health psychology
  • Neurorehabilitation
  • Pain management

ASJC Scopus subject areas

  • Psychology(all)

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  • Cite this

    Castelnuovo, G., Giusti, E. M., Manzoni, G. M., Saviola, D., Gatti, A., Gabrielli, S., Lacerenza, M., Pietrabissa, G., Cattivelli, R., Spatola, C. A., Corti, S. P., Novelli, M., Villa, V., Cottini, A., Lai, C., Pagnini, F., Castelli, L., Tavola, M., Torta, R., ... Zerbinati, P. (2016). 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. Frontiers in Psychology, 7(APR), [00468]. https://doi.org/10.3389/fpsyg.2016.00468