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Differential efficacy between cognitive-behavioral therapy and mindfulness-based therapies for chronic pain: Systematic review
International Journal of Clinical and Health Psychology ( IF 5.900 ) Pub Date : 2020-10-23 , DOI: 10.1016/j.ijchp.2020.08.001
Estela M. Pardos-Gascón , Lucas Narambuena , César Leal-Costa , Carlos J. van-der Hofstadt-Román

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.



中文翻译:

认知行为疗法与正念疗法对慢性疼痛的疗效差异:系统评价

背景/目的:评估基于正念的干预措施与认知行为疗法(CBT)在涉及疼痛的医疗条件下对慢性疼痛的疗效差异。方法:搜索ProQuest,Science Direct,Google Scholar,Pubmed和Embase数据库,以鉴定随机临床试验。包括对正念,疼痛,情绪和其他杂项测量的测量。结果: 18项研究符合纳入标准(纤维肌痛,n = 5;腰痛,n = 5;头痛/偏头痛,n = 4;非特异性慢性疼痛,n= 4)。在纤维肌痛中,基于正念的压力减轻(MBSR)在影响和症状方面优于常规护理和Fibroqol。在下腰痛中,MBSR在身体功能和疼痛强度方面优于常规护理,但不优于CBT。尚无关于正念与CBT对头痛和非特异性慢性疼痛的疗效差异的研究,但在这些综合征中,正念干预优于常规治疗。结论:正念干预在所有诊断中均优于常规护理,但不可能得出其优于CBT的结论。正念干预之间的比较很少,对MBSR的研究最多。在中枢致敏综合征中,与疼痛有关的变量往往会随着治疗而改善。需要更多的研究来区分诊断和干预。

更新日期:2020-12-17
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