Psychological treatments and psychotherapies in the neurorehabilitation of pain: Evidences 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, Valentino Romano, 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 journalReview article

Abstract

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.

Original languageEnglish
Article number115
JournalFrontiers in Psychology
Volume7
Issue numberFEB
DOIs
Publication statusPublished - 2016

Keywords

  • Chronic pain
  • Clinical psychology
  • Health psychology
  • Neurological rehabilitation
  • Pain
  • Psychological treatments
  • Psychotherapy

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 treatments and psychotherapies in the neurorehabilitation of pain: Evidences and recommendations from the italian consensus conference on pain in neurorehabilitation. Frontiers in Psychology, 7(FEB), [115]. https://doi.org/10.3389/fpsyg.2016.00115