Cárdenas Katherine, Aranda Mariana
Psiquiatra general y Psiquiatra de enlace, Departamento de psiquiatría y salud mental, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia.
Psiquiatra general y Fellow de psiquiatría de enlace, Departamento de psiquiatría y salud mental, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia.
Rev Colomb Psiquiatr. 2017 Jul-Sep;46(3):178-186. doi: 10.1016/j.rcp.2016.08.003. Epub 2016 Sep 6.
The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42 to 90% of amputees. Regular drug treatment of phantom limb pain is almost never effective.
A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items. After reviewing the abstracts, 25 articles were excluded for not being related to the objective of the research. Additionally cross references of included articles and literature were reviewed.
To describe the psychotherapies used in the management of phantom limb pain, their effectiveness and clinical application reported in the literature.
The mechanisms underlying phantom limb pain were initially explained, as were the published studies on the usefulness of some psychotherapies such as mirror visual feedback and immersive virtual reality, visual imagery, desensitization and reprocessing eye movements and hypnosis.
The phantom limb pain is a complex syndrome that requires pharmacological and psychotherapeutic intervention. The psychotherapies that have been used the most as adjuvants in the treatment of phantom limb pain are mirror visual feedback, desensitization and reprocessing eye movements, imagery and hypnosis. Studies with more representative samples, specifically randomized trials are required.
幻肢痛被描述为一种患者在先前已被截肢的肢体或身体部位体验到瘙痒、痉挛或疼痛感觉的病症。这种疼痛可能由先前健康肢体的视觉和本体感觉反馈表征之间的冲突引发。至少42%至90%的截肢者会出现幻肢痛。常规药物治疗幻肢痛几乎从未有效。
在Medline和Cochrane中使用医学主题词“幻肢痛”和“心理治疗”对过去10年以英文和西班牙文发表的文献进行系统综述，共找到49篇文章。在审阅摘要后，排除了25篇与研究目标无关的文章。此外，还对纳入文章的交叉参考文献和文献进行了审阅。
描述用于管理幻肢痛的心理治疗方法、其有效性以及文献中报道的临床应用。
最初解释了幻肢痛的潜在机制，以及一些心理治疗方法（如镜像视觉反馈、沉浸式虚拟现实、视觉意象、脱敏和眼动再处理以及催眠）有用性的已发表研究。
幻肢痛是一种复杂的综合征，需要药物和心理治疗干预。在幻肢痛治疗中最常作为辅助手段使用的心理治疗方法是镜像视觉反馈、脱敏和眼动再处理、意象和催眠。需要有更具代表性样本的研究，特别是随机试验。
