目的:由于基于心理的干预措施已被证明对患有慢性疼痛的成年人具有临床效用,在慢性神经性疼痛(NeuP)的治疗中,可能会有类似的获益.然而,到目前为止,这还没有确定,由于随机对照试验(RCTs)的稀缺,因此有关该主题的现有系统综述受到阻碍。这篇综述旨在确定针对慢性NeuP成年人研究的基于心理的干预措施的类型。它还旨在评估是否有足够的RCT来证明进行最新的系统审查是合理的。
方法:从数据库开始到2021年12月,搜索了七个数据库和两个临床试验注册中心的NeuP和基于心理的干预措施,并于2023年2月进行了更新。通过审查纳入研究的参考清单和联系现场专家,扩大了搜索范围。提取预定的研究特征。
结果:在筛选的4682条记录中,33篇(少于1%)文章符合资格标准。观察到四种广泛的干预方法,包括认知行为方法(n=16),正念/冥想(n=10),创伤聚焦治疗(n=4),催眠(n=3)。确定了13个RCT,其中,9人在治疗后保留了20名参与者.
结论:认知行为疗法是最常见的治疗方法,而正念/冥想是最常用的技术。几乎一半到三分之二的研究报告了两种疼痛的显着改善,残疾,或痛苦,这表明基于心理的干预措施可能对患有慢性NeuP的成年人有益。更新的系统审查似乎是必要的。
OBJECTIVE: As psychologically based interventions have been shown to have clinical utility for adults with chronic pain generally, a similar benefit might be expected in the management of chronic neuropathic pain (NeuP). However, to date, this has not been established, with existing systematic reviews on this topic being hampered by the scarcity of randomized controlled trials (RCTs). This review aimed to identify the type of psychologically based interventions studied for adults with chronic NeuP. It also aimed to assess whether there are enough RCTs to justify undertaking an updated systematic review.
METHODS: Seven databases and 2 clinical trial registries were searched for NeuP and psychologically based interventions from database inception to December 2021, and the search was updated in February 2023. The search was broadened by reviewing the reference list of included studies and contacting field experts. Predetermined study characteristics were extracted.
RESULTS: Of 4682 records screened, 33 articles (less than 1%) met the eligibility criteria. Four broad intervention approaches were observed, including cognitive-behavioral approaches (n = 16), mindfulness/meditation (n = 10), trauma-focused therapy (n = 4), and hypnosis (n = 3). Thirteen RCTs were identified, and of these, 9 retained 20 participants in each arm after treatment.
CONCLUSIONS: Cognitive-behavioral therapy was the most common therapeutic approach identified, whereas mindfulness/meditation was the most frequently used technique. Almost half to two-thirds of the studies reported significant improvements in pain, disability, or distress, which suggests that psychologically based interventions are potentially beneficial for adults with chronic NeuP. An updated systematic review seems warranted.
BACKGROUND: Open Science Framework (https://osf.io) (December 6, 2021; DOI: 10.17605/OSF.IO/WNSTM).