Cited by 175Mindfulness and Compassion InterventionsMusculoskeletal pain and rehabilitationPain Management and Treatment

Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioural therapy for the treatment and management of chronic pain: A systematic review and network meta-analysis

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Khoo, Eve-Ling, Small, Rebecca, Cheng, Wei, Hatchard, Taylor, Glynn, Brittany, Rice, Danielle B, Skidmore, Becky, Kenny, Samantha +2 more·2019·Evidence Based Mental Health

Abstract

Question: This review compares mindfulness-based stress reduction (MBSR) to cognitive-behavioural therapy (CBT) in its ability to improve physical functioning and reduce pain intensity and distress in patients with chronic pain (CP), when evaluated against control conditions. Study selection and analysis: Ovid MEDLINE, EmbaseClassic+Embase, PsycINFO and the Cochrane Library were searched to identify randomised controlled trials. The primary outcome measure was physical functioning. Secondary outcomes were pain intensity and depression symptoms. We used random and fixed effects (RE and FE) network meta-analyses (NMA) to compare MBSR, CBT and control interventions on the standardised mean difference scale. Findings: Twenty-one studies were included: 13 CBT vs control (n=1095), 7 MBSR vs control (n=545) and 1 MBSR vs CBT vs control (n=341). Of the 21 articles, 12 were determined to be of fair or good quality. Findings from RE NMA for change in physical functioning, pain intensity and depression revealed clinically important advantages relative to control for MBSR and CBT, but no evidence of an important difference between MBSR and CBT was found. Conclusions: This review suggests that MBSR offers another potentially helpful intervention for CP management. Additional research using consistent measures is required to guide decisions about providing CBT or MBSR.

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Crossref · 10.1136/ebmental-2018-300062

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  • The findings are reassuring that patients with chronic low back pain, regardless of the baseline characteristics examined to date, could reasonably expect benefit from either CBT or MBSR.

    “Our findings are reassuring that patients with CLBP, regardless of these baseline characteristics examined to date, could reasonably expect to benefit from either CBT or MBSR.44”

    From Moderators and Nonspecific Predictors of Treatment Benefits in a Randomized Trial of Mindfulness-Based Stress Reduction vs Cognitive-Behavioral Therapy vs Usual Care for Chronic Low Back Pain (2023) · cites this paper as [44]

    The Conclusions and Clinical Implications and Limitations and Recommendations sections (page numbers unavailable) report benefits from both CBT and MBSR for adults with chronic pain; the review included some chronic low back pain studies. It does not establish benefit regardless of baseline characteristics, and explicitly says it cannot yet determine which intervention might be more beneficial for patients with different pain, medical, and psychosocial presentations. (LLM, conf=0.85)

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  • Compared to TAU, MBI produced a significant reduction at post-treatment in depressive symptoms, in one out of two studies, and an increase in emotional awareness and self-regulation, in the one study that addressed this.

    “As in previous research in chronic pain (Veehof et al., 2016; Hilton et al., 2017; Khoo et al., 2019), compared to TAU, MBI produced a significant reduction at post-treatment in depressive symptoms, in one out of two studies (De Jong et al., 2018), and an increase in emotional awareness and self-regulation, in the one study that addressed this (De Jong et al., 2016).”
  • There is some evidence for specific effects of different forms of meditation practice on both the brain and behavior with longer and more intensive practice.

    “There is some evidence for specific effects of different forms of meditation practice on both the brain and behavior with longer and more intensive practice163–167.”

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Authors
Khoo, E.-L., Small, R., Cheng, W., Hatchard, T., Glynn, B., Rice, D. B., Skidmore, B., Kenny, S., Hutton, B., & Poulin, P. A.
Affiliations
  • Ottawa Hospital Research Institute (CA)
  • Memorial University of Newfoundland (CA)
  • University of Ottawa (CA)
Corresponding author
Poulin, Patricia A
Venue
Evidence Based Mental Health
Publisher
BMJ
Published
2019-01-31
Volume
22
Issue
1
Pages
26-35
ISSN
  • 1362-0347 (ISSN-L)
  • 1468-960X
OpenAlex
W2913124466
Cited by
175
References
40
Citations by year
2026: 10 · 2025: 16 · 2024: 16 · 2023: 39 · 2022: 39 · 2021: 23 · 2020: 25 · 2019: 5 · 2014: 1
FWCI
3.63
Type
journal article
Language
en
Open access
Locations
  • Evidence-Based Mental Health (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
Funders
Canadian Institutes of Health Research
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords
mindfulness-based stress reduction, cognitive behavioral therapy, chronic pain, physical function, pain intensity, depression, group intervention, psychological pain management
MeSH terms
Humans, Psychotherapy, Group, Stress, Psychological, Cognitive Behavioral Therapy, Outcome Assessment, Health Care, Chronic Pain, Mindfulness

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