Psychological factors influencing chronic phantom limb pain: an analysis of the literature.

The behavioral literature concerning chronic phantom limb pain was reanalyzed in order to determine the role of psychological factors in initiating and controlling the intensity of its episodes. Some of the behavioral literature presents an inaccurate picture of amputees who have phantom pain. This apparently happened because many of the data were gathered from those amputees requesting treatment for phantom pain who were referred to mental health professionals. We conclude that phantom pain is similar to other chronic pain syndromes in that episodes are greatly influenced by psychological factors such as stress and depression. Repeated requests for treatment are influenced by personality structure. There is no convincing evidence that major personality disorders are important in the etiology of chronic phantom pain nor that they are more prevalent among those amputees reporting phantom pain than among those not reporting it.