A Cochrane review measured the effectiveness of cognitive psychotherapy (CBT) on chronic pain. A meta-analysis on CBT vs usual care/waiting list suggested little improvement in pain (standardized mean difference [SMD] -0.22, 95 % CI -0.33 to -0.10). This translates to about 8 % decrease in pain (95 % CI 4 % to 11 %).
Cognitive therapy likely decreases disability slightly (SMD -0.32, 95 % CI -0.45 to -0.19) and likely decreases distress (SMD -0.34. 95 % CI -0.44 to -0.24) at the end of treatment.
The quality of evidence was limited due to high risk of bias.
| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias |
|---|---|---|---|---|---|
| RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis | |||||
| «Williams ACC, Fisher E, Hearn L, et al. Psychologi...»1 | SR/MA | Adults with chronic pain | Psychological therapies vs usual care or active control | Pain, disability, and distress | high |
| Reference | Comments |
|---|---|
| «Williams ACC, Fisher E, Hearn L, et al. Psychologi...»1 | All trials had either unclear or high risk of bias, due to unclear or missing reporting. |
Results
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Mean (sd) | Mean (sd) | Standardized mean difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: moderate Assess the risk of bias and delete irrelevant sources of bias: The quality of evidence was limited due to high risk of bias. I=intervention; C=comparison; CI=confidence interval |
|||||
| «Williams ACC, Fisher E, Hearn L, et al. Psychologi...»1 | 29 studies, 2572 patients | not reported | - | - | -0.22 (-0.33 to -0.1)
Ratio of means: 0.92 (0.89 to 0.96) |
| Reference | Number of studies and number of patients (I/C) | Follow-up time | Mean (sd) | Mean (sd) | Standardized mean difference (95% CI) |
|---|---|---|---|---|---|
| Level of evidence: low Assess the risk of bias and delete irrelevant sources of bias: The quality of evidence was limited due to high risk of bias. I=intervention; C=comparison; CI=confidence interval |
|||||
| «Williams ACC, Fisher E, Hearn L, et al. Psychologi...»1 | 15 studies, 1581 patients | not reported | - | - | -0.32 (-0.45 to -0.19) Ratio of means: 0.87 (0.82 to 0.92) |