Researchers from the University of Twente
in The Netherlands assessed the effects of acceptance-based interventions on
patients with chronic pain. [Acceptance-based interventions such as
Mindfulness-Based Stress Reduction (MBSR) and Acceptance and Commitment Therapy
(ACT) are alternative therapies for cognitive behavioral therapy for treating
chronic pain patients.]
The investigators
conducted a systematic review and meta-analysis of controlled and non-controlled
studies that reported effects on mental and physical health of pain patients.
All studies were rated for quality. Primary
outcomes measured were pain intensity and depression. Secondary outcomes
measured were anxiety, physical well-being and quality of life.
Twenty-two studies (9
randomized controlled studies, 5 clinical controlled studies without
randomization, and 8 non-controlled studies) were included, totaling 1235
patients with chronic pain. An effect
size on pain of 0.37 was found for the controlled studies. The effect on
depression was 0.32. The quality of the studies was not found to moderate the
effects of these acceptance-based interventions.
The results suggest
that at present mindfulness-based stress reduction programs and acceptance and
commitment therapy are not superior to cognitive behavioral therapy, but can be
just-as-good alternatives to it.
Acceptance-based
therapies have small to medium effects on physical and mental health in chronic
pain patients. These effects are comparable to those of cognitive behavioral
therapy. More high-quality studies are needed.
The investigators recommended studies that focus on therapies that
integrate mindfulness and behavioral therapy.
Citation: Veehof MM, Oskam MJ, Schreurs KM, Bohlmeijer ET. Acceptance-based
interventions for the treatment of chronic pain: a systematic review and
meta-analysis. Pain. 2011 Mar;152 (3):533-42.
Epub 2011 Jan 19. m.m.veehof@utwente.nl
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