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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
Open accessAbstract
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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“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]
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“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).”
From A systematic review of cognitive behavioral therapy-based interventions for comorbid chronic pain and clinically relevant psychological distress (2023) · cites this paper as Khoo et al., 2019
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“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.”
From A common factors perspective on mindfulness-based interventions (2022) · cites this paper as [167]
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Mindfulness-based interventions: an overall review
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“A network metaanalysis found MBSR is effective for chronic pain, and the effects are not significantly different between MBSR and CBT; though more studies are needed to confirm this.(41) Furthermore, for the effects of brief MBIs with a total contact time of less than 1.”
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Metadata
- 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
- ORCID
- 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
- PMC
- PMC10270397
- 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
- FWCI
- 3.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- 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 › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › 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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