Department of Oncology, IRCCS Casa Sollievo della Sofferenza Hospital, S. Giovanni Rotondo, Bari, Italy.
Psychother Psychosom. 2010;79(3):156-63. doi: 10.1159/000286960. Epub 2010 Feb 20.
Alexithymia is likely to be involved in the pain experience of cancer patients, but the extent to which psychological interventions may modify both pain and alexithymia is unclear.
A group of 52 consecutive cancer patients were enrolled in a 6-month multicomponent psychological intervention trial, and compared to 52 control patients who received standard medical care. Validated scales for pain, alexithymia, coping with disease, illness behavior, psychological distress, and psychosocial functioning were administered at baseline and 6 months later.
Pain was strongly associated with alexithymia and several psychological dimensions. Although at baseline patients in the intervention group had worse psychological and somatic health, at follow-up their level of pain intensity, alexithymia, and somatic concerns had significantly improved compared to control patients. Patients in the intervention group showed dramatic improvements in pain perception, alexithymia, and other psychological variables, while control patients showed an unexpected significant worsening of alexithymia, depression, and adjustment to disease. Multiple regression showed that psychological intervention and alexithymia were both independently associated with the reduction in pain perception.
These findings confirm the close association between alexithymia and pain, and show that multicomponent psychological intervention may significantly reduce both alexithymia and cancer pain. Although the present findings need replication, they should strongly encourage clinicians to provide patients with psychological interventions targeting alexithymic difficulties and helping patients to cope better with both feelings and somatic perception.
述情障碍可能与癌症患者的疼痛体验有关,但心理干预对疼痛和述情障碍的影响程度尚不清楚。
一组 52 例连续癌症患者参加了为期 6 个月的多组分心理干预试验,并与接受标准医疗护理的 52 例对照患者进行比较。在基线和 6 个月后,使用经过验证的疼痛、述情障碍、疾病应对、疾病行为、心理困扰和心理社会功能量表进行评估。
疼痛与述情障碍和几个心理维度密切相关。尽管在基线时干预组患者的心理和躯体健康状况较差,但随访时,与对照组患者相比,他们的疼痛强度、述情障碍和躯体担忧水平显著改善。干预组患者在疼痛感知、述情障碍和其他心理变量方面表现出显著改善,而对照组患者的述情障碍、抑郁和疾病适应方面却出现了意外的显著恶化。多元回归分析显示,心理干预和述情障碍均与疼痛感知的降低独立相关。
这些发现证实了述情障碍与疼痛之间的密切关系,并表明多组分心理干预可能显著减轻述情障碍和癌症疼痛。尽管目前的发现需要复制,但它们应该强烈鼓励临床医生为患者提供针对述情障碍困难的心理干预,并帮助患者更好地应对情感和躯体感知。