Psychological Therapy in Chronic Pain: Differential Efficacy between Mindfulness-Based Cognitive Therapy and Cognitive Behavioral Therapy.

The objective of this study is to evaluate the differential efficacy between Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavioral Therapy (CBT). A quasi-experimental design of repeated measures before and after the test (n = 57) was used with a non-equivalent control group from a previous cohort treated with CBT (n = 105). The t-test revealed significant differences in subjective quality of life for the MBCT group, and in quantity, optimum, and adequate sleep for the CBT group. The pre-post effect size comparison mostly showed slightly larger effect sizes in the MBCT group. CBT and MBCT had comparable efficacies, although a slight trend towards larger effect sizes in MBCT was found. Likewise, CBT seemed to improve sleep-related variables, while MBCT was associated with improvements in pain and quality of life.

Effects of Mindfulness-Based Cognitive Therapy for Chronic Pain: A Multicenter Study.

The prevalence of chronic pain in Spain is 15%. The objective of this study was to evaluate the efficacy of mindfulness-based cognitive therapy on patients with chronic pain. A quasi-experimental design of repeated measures pre- and post-test (N = 57) was carried out at three hospitals from the province of Alicante. Self-reported assessment measurements of pain intensity, anxiety-depression symptoms, perception of health status, interference of pain on sleep, self-efficacy in pain, acceptance, and mindfulness attitude were included. The T-test indicates significant differences in intensity of present pain, mental quality of life, and depression (medium effect sizes), as well as in self-efficacy: total score, symptom management and pain control (medium effect sizes), sleep disturbances and quantity of sleep (large effect sizes). MBCT is effective in reducing many symptoms in patients with chronic pain, although its maintenance needs to be further investigated.

Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review / Eficacia diferencial entre terapia cognitivo-conductual y terapias basadas en mindfulness para dolor crónico: revisión iistemática

Background/Objective: To assess the differential efficacy between mindfulness-based interventions and cognitive-behavioral Therapy (CBT) on chronic pain across medical conditions involving pain. Method: ProQuest, Science Direct, Google Scholar, Pubmed, and Embase databases were searched to identify randomized clinical trials. Measurements of mindfulness, pain, mood, and further miscellaneous measurements were included. Results: 18 studies met the inclusion criteria (fibromyalgia, n = 5; low back pain, n = 5; headache/migraine, n = 4; non-specific chronic pain, n = 4). In fibromyalgia, mindfulness based stress reduction (MBSR) was superior to the usual care and Fibroqol, in impact and symptoms. In low back pain, MBSR was superior to the usual care, but not to CBT, in physical functionality and pain intensity. There were no studies on differential efficacy between mindfulness and CBT for headache and non-specific chronic pain, but Mindfulness interventions were superior to the usual care in these syndromes. Conclusions: Mindfulness interventions are superior to usual cares in all diagnoses, but it is not possible to conclude their superiority over CBT. Comparisons between mindfulness interventions are scarce, with MBSR being the most studied. In central sensitization syndromes, variables associated with pain tend to improve with treatment. More research is needed to differentiate diagnosis and intervention. (AU)

Introducción/Objetivo: Estudiar la eficacia diferencial entre terapias basadas en mindfulness y terapia cognitivo-conductual (TCC) en síndromes asociados a dolor crónico. Método: ProQuest, Science Direct, Google Scholar, Pubmed y Embase fueron las bases utilizadas para identificar los ensayos clínicos aleatorizados. Los resultados fueron medidas de mindfulness, dolor, estado de ánimo y otras. Resultados: 18 estudios cumplieron criterios de inclusión (fibromialgia, n = 5; lumbalgia, n = 5; cefalea/migraña, n = 4; dolor crónico no especificado, n = 4). En fibromialgia, la terapia basada en mindfulness para la reducción del estrés (MBSR, por sus siglas en inglés) fue superior a tratamiento habitual y Fibroqol en impacto y sintomatología. En lumbalgia, MBSR fue superior a tratamiento habitual, pero no frente a TCC, en funcionalidad física e intensidad del dolor. No se encontraron estudios de eficacia diferencial entre mindfulness y TCC en cefalea y dolor crónico no especificado, pero las intervenciones mindfulness fueron superiores a tratamiento habitual en estos síndromes. Conclusiones: Las intervenciones mindfulness son superiores al tratamiento habitual en todos los diagnósticos, pero no es posible concluir su superioridad sobre TCC. Son escasas las comparaciones entre intervenciones mindfulness, siendo MBSR la más estudiada. En síndromes de sensibilización central tienden a mejorar variables asociadas al dolor. Es necesaria más investigación diferenciando diagnóstico e intervención. (AU)

Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review.

Background/Objective: To assess the differential efficacy between mindfulness-based interventions and cognitive-behavioral Therapy (CBT) on chronic pain across medical conditions involving pain. Method: ProQuest, Science Direct, Google Scholar, Pubmed, and Embase databases were searched to identify randomized clinical trials. Measurements of mindfulness, pain, mood, and further miscellaneous measurements were included. Results: 18 studies met the inclusion criteria (fibromyalgia, n = 5; low back pain, n = 5; headache/migraine, n = 4; non-specific chronic pain, n = 4). In fibromyalgia, mindfulness based stress reduction (MBSR) was superior to the usual care and Fibroqol, in impact and symptoms. In low back pain, MBSR was superior to the usual care, but not to CBT, in physical functionality and pain intensity. There were no studies on differential efficacy between mindfulness and CBT for headache and non-specific chronic pain, but Mindfulness interventions were superior to the usual care in these syndromes. Conclusions: Mindfulness interventions are superior to usual cares in all diagnoses, but it is not possible to conclude their superiority over CBT. Comparisons between mindfulness interventions are scarce, with MBSR being the most studied. In central sensitization syndromes, variables associated with pain tend to improve with treatment. More research is needed to differentiate diagnosis and intervention.

Introducción/Objetivo: Estudiar la eficacia diferencial entre terapias basadas en mindfulness y terapia cognitivo-conductual (TCC) en síndromes asociados a dolor crónico. Método: ProQuest, Science Direct, Google Scholar, Pubmed y Embase fueron las bases utilizadas para identificar los ensayos clínicos aleatorizados. Los resultados fueron medidas de mindfulness, dolor, estado de ánimo y otras. Resultados: 18 estudios cumplieron criterios de inclusión (fibromialgia, n = 5; lumbalgia, n = 5; cefalea/migraña, n = 4; dolor crónico no especificado, n = 4). En fibromialgia, la terapia basada en mindfulness para la reducción del estrés (MBSR, por sus siglas en inglés) fue superior a tratamiento habitual y Fibroqol en impacto y sintomatología. En lumbalgia, MBSR fue superior a tratamiento habitual, pero no frente a TCC, en funcionalidad física e intensidad del dolor. No se encontraron estudios de eficacia diferencial entre mindfulness y TCC en cefalea y dolor crónico no especificado, pero las intervenciones mindfulness fueron superiores a tratamiento habitual en estos síndromes. Conclusiones: Las intervenciones mindfulness son superiores al tratamiento habitual en todos los diagnósticos, pero no es posible concluir su superioridad sobre TCC. Son escasas las comparaciones entre intervenciones mindfulness, siendo MBSR la más estudiada. En síndromes de sensibilización central tienden a mejorar variables asociadas al dolor. Es necesaria más investigación diferenciando diagnóstico e intervención.