Table 1

Characteristics of included studies and results

First author, YearIntervention (I)/Intervention 2 (I2)/Control (C) N PopulationOutcome measures analysedTherapist qualificationsTreatment adherenceResults
Mean (SD)
Physical
functioning
Pain intensityDepression
Alda, 201120 CBT/SC113Fibromyalgia
18–65 years
  1. FIQ

  2. HAM-D

  3. VAS

Trained therapists from the Torrero Health CentreRandom sessions were audio-recorded and assessed by team membersFIQ:
Pre: I, 65.91 (10.85); C: 64.48 (10.50)
Post: I, 46.21 (9.18); C, 48.64 (6.77)
VAS:
Pre: I, 64.20 (10.78); C, 64.72 (10.44)
Post: I, 36.88 (8.29); C, 38.68 (7.48)
HAM-D:
Pre: I, 14.47 (3.93); C, 14.09 (4.64)
Post: I, 7.78 (2.46); C, 8.17 (2.25)
Cash, 201531 MBSR/WL91Fibromyalgia
≥18 years
  1. VAS

  2. FIQ

Professional internship training programme at the UMass Medical Centre Stress Reduction ClinicInformation not providedFIQ:
Pre: I, 1.30 (0.72); C, 1.20 (0.75)
Post: I, 1.20 (0.73); C, 1.20 (0.84)
VAS:
Pre: I, 68.10 (25.40); C, 69.20 (19.60)
Post: I, 60.40 (26.40); C, 68.50 (23.50)
Castel, 200933 CBT/SC23Fibromyalgia
18–60 years
  1. Average Pain Intensity (NRS)

  2. FIQ

Information not providedInformation not providedFIQ:
Pre: I, 67.44 (16.08); C, 72.14 (8.95)
Post: I, 60.96 (22.69); C, 66.14 (18.81)
NRS:
Pre: I, 6.16 (1.69); C, 6.60 (1.18)
Post: I, 6.10 (2.52); C, 7.00 (1.01)
Cherkin, 201634 MBSR/CBT/SC341Chronic low back pain
20–70 years
  1. RDQ

  2. Characteristic pain intensity (NRS)

  3. PHQ-8

MBSR: Training from the Centre for Mindfulness at the UMass
Medical School with experience of 5–29 years in MBSR.
CBT: Licensed PhD-level psychologists experienced in group and individual CBT for chronic pain
Sessions were audio recorded and a study investigator monitored instructors’ adherence to the protocol, either in person or via audio recording, for at least one session per groupRDQ (mean difference):
I, −3.40 (−4.22 to −2.59); I2, −3.37 (−4.14 to −2.60); C, −1.83 (−2.59 to −1.07)
NRS (mean difference):
I, −1.00 (−1.28 to −0.73); I2, −0.86 (-1.12 to −0.59); C, −0.37 (−0.62 to −0.12)
PHQ-8 (mean difference):
I, −1.60 (−2.15 to −1.05); I2, −2.29 (−2.66 to −1.92); C, −0.12 (−0.74 to −0.50)
Esmer, 201035 MBSR/SC25Failed back surgery syndrome
  1. RMDQ

  2. VAS

Psychotherapist and osteopath physician who is board certified in neuromusculoskeletal medicine. Both teachers completed the MBSR Teacher Development Intensive (TDI) from the UMass Medical CenterInformation not providedRMDQ:
Pre: I, 6.7 (5.1); C, 7.2 (5.0)
Post: I, 3.1 (3.4); C, 7.3 (1.9)
VAS:
Pre: I, 23.20 (5.00); C, 24.30 (7.80)
Post: I, 16.36 (6.90); C, 24.10 (6.00)
Falcão, 200836 CBT/SC51Fibromyalgia
18–65 years
  1. VAS

  2. BDI

Physician trained in CBT techniquesInformation not providedVAS:
Pre: I, 6.88 (2.29); C, 7.03 (2.25)
Post: I, 3.28 (3.58); C, 3.53 (2.88)
BDI:
Pre: I, 20.60 (9.96); C, 25.76 (8.46)
Post: I, 7.56 (7.71); C, 13.96 (11.37)
Jensen, 201237 CBT/WL43Fibromyalgia
18–55 years
  1. VAS

  2. BDI

Psychologists trained in CBTInformation not providedVAS:
Pre: I, 61(20); C, 65(10)
Post: I, 49(19); C, 59(26)
BDI:
Pre: I, 16(6); C, 19(12)
Post: I, 11(5); C, 16 (10
Kearney, 201638 MBSR/SC55Gulf war illness
  1. MPQ

  2. PHQ-9

Information not providedInformation not providedMPQ:
Pre: I, 75.00 (32.50); C, 81.20 (41.90)
Post: I, 54.00 (44.20); C, 65.50 (43.40)
PHQ-9:
Pre: I, 14.40 (5.50); C, 12.80 (5.20)
Post: I, 10.20 (6.20); C, 12.40 (6.70)
Keefe, 199039 CBT/SC63Osteoarthritis of the knee
≥18 years
  1. AIMS

Psychologists with experience in cognitive-behavioural pain management group therapy; therapists received training in intervention and weekly supervisionIndependent ratings of audiotapes of treatment sessions conductedAIMS-physical disability:
Pre: I, 1.98 (0.98); C, 1.87 (1.20)
Post: I, 2.01 (1.32); C, 2.00 (1.26)
AIMS-pain:
Pre: I, 5.44 (2.05); C, 5.76 (1.62)
Post: I, 4.55 (1.72); C, 5.68 (1.62)
Kraaimaat, 199521 CBT/SC43Rheumatoid arthritis)
≥20 years
  1. IRGL

Clinical psychologist trained in CBT and supervised by a behaviour therapistSessions tape recorded and reviewed by supervising behaviour therapistIRGL-function:
Pre: I, 20.70 (5.30); C, 19.40 (6.80)
Post: I, 14.80 (4.30); C, 19.50 (6.60)
IRGL-depression:
Pre: I, 2.0 (2.2); C, 3.2 (3.2)
Post: I, 3.1 (3.5); C, 2.5 (2.5)
La Cour, 201522 MBSR/SC109Non-specific chronic pain
19 - 76 years
  1. BPI

  2. SF-36

  3. HADS

Training and certification with Jon Kabat-Zinn and colleagues at the Centre for Mindfulness in Medicine, Healthcare and Society at the UMass; some small parts of the sessions were conducted by a fellow MBSR teacher under close supervision by the main teacher to ensure treatment integrityInformation not providedSF-36:
Pre: I, 45.40 (23.80); C, 45.20 (20.60)
Post: I, 48.30 (25.80); C, 48.60 (21.30)
BPI:
Pre: I, 19.00 (6.60); C, 19.20 (5.20)
Post: I, 18.80 (5.90); C, 17.90 (5.60)
HADS:
Pre: I, 7.10 (4.50); C, 7.60 (4.70)
Post: I, 5.90 (4.30); C, 7.60 (4.80)
Langford, 200823 CBT/attention control101Fibromyalgia
≥18 years
  1. FIQ

  2. Pain (NRS)

  3. SCL90-R

Information not providedInformation not providedFIQ:
Pre: I, 57.37 (15.38); C, 53.23 (15.36)
Post: I, 51.24 (19.28); C, 52.70 (15.70)
NRS:
Pre: I, 213.42 (63.20); C, 199.21 (56.63)
Post: I, 203.01 (68.90); C, 203.86 (66.57)
SCL90-R:
Pre: I, 1.68 (0.89); C, 1.41 (0.76)
Post: I, 1.51 (0.97); C, 1.36 (0.78)
Mishra, 200024 CBT/SC47Temporomandibular disorders
18–65 years
  1. CPI

Clinical psychologists and advanced doctoral students clinical psychology programme; therapists received individual and group training and weekly supervision by licensed psychologist on the teamTreatment sessions were recorded and the audiotapes were randomly reviewed using the Therapist Competency Rating formCPI:
Pre: I, 54.49 (15.49);
C, 47.74 (17.48)
Post: I, 41.51 (16.83)
C, 42.53 (23.56)
Pradhan, 200725 MBSR/SC63Rheumatoid arthritis
≥18 years
  1. SCL90-R

Certified MBSR teachers from the Centre for Mindfulness at UMass Medical SchoolInformation not providedSCL90-R:
Pre: I, 0.66 (0.50); C, 0.56 (0.51)
Post: I, 0.43 (0.45); C, 0.40 (0.45)
Puder, 198826 CBT/WL69Any chronic pain condition
≥21 years
  1. DPD

Information not providedInformation not providedDPD:
Pre: I, 2.99 (0.76); C, 2.95 (0.75)
Post: I, 2.62 (0.81); C, 2.97 (0.68)
DPD:
Pre: I: 3.49 (0.76) high; 1.73 (0.86) low
C, 3.40 (0.65) high; 1.68 (0.66) low;
Post: I, 3.19 (0.89) high; 1.87 (0.97) low;
C, 3.26 (0.66) high; 1.73 (0.76) low
Schmidt, 201127 MBSR/WL112Fibromyalgia
18–70 years
  1. CES-D

University-level degrees in educational counselling; training in MBSR from the UMass Medical school and 7 years of experience teaching MBSRInformation not providedCES-D
Pre: I, 25.19 (9.60); C, 25.43 (9.26)
Post: I, 23.20 (9.04); C, 15.10 (8.10)
Sephton, 200728 MBSR/WL90Fibromyalgia
≥18 years
  1. BDI

Licensed clinical psychologist who trained in MBSR at UMass Medical SchoolInformation not providedBDI:
Pre: I, 15.7 (7.1); C, 14.7 (6.9)
Post: I, 12.4 (7.4); C, 15.1 (8.1)
Shpaner, 201429 CBT/attention control38Chronic musculoskeletal pain
19–59 years
  1. CPSS

  2. TOPS

Information not providedInformation not providedCPSS:
Pre: I, 7.32 (1.99); C, 8.19 (2.50)
Post: I, 8.14 (1.99); C, 8.50 (1.84)
TOPS:
Pre: I, 67.51 (17.74); C,60.62 (14.00)
Post: I, 53.43 (20.50); C, 58.17 (15.60)
Smeets, 200614 CBT/SC104Chronic low back pain
18–65 years
  1. RMDQ

  2. VAS

  3. BDI

Clinical psychologist or social worker trained in CBTObservations by independent researcher of all active treatments via on-site visits, audio and video recordingsRMDQ (mean difference):
−3.09 (-4.89 to
−1.28)
VAS (mean difference):
−15.64 (−24.23 to
−7.06)
BDI (mean difference): −1.65 (−3.42 to 0.12)
Turner, 198830 CBT/WL45Chronic low back pain
20–65 years
  1. SIP

  2. MPQ

Clinical psychologists with previous supervised clinical experience with CBT treatment for chronic painPretreatment and post-treatment analysis of therapists’ beliefs and confidence in treatment techniquesSIP:
Pre: I, 7.70 (6.15); C, 9.25 (9.12)
Post: I, 5.39 (3.91); C, 5.74 (6.90)
MPQ:
Pre: I, 18.30 (10.43); C, 22.57 (13.67)
Post: I, 15.91 (11.63); C, 22.14 (12.35)
Vallejo, 201532 CBT/SC60Fibromyalgia
≥18 years
  1. CPSS

  2. BDI

Doctoral-level clinical psychologist with extensive experience in CBT with patients with fibromyalgiaInformation not providedCPSS:
Pre: I, 40.95 (20.46); C, 50.86 (23.68)
Post: I, 45.45 (21.34); C, 47.90 (21.31)
BDI:
Pre: I, 21.49 (6.95); C,18.55 (7.75)
Post: I, 16.38 (4.15); C, 18.83 (7.41)
  • AIMS, Arthritic Impact Measurement Scale; BDI, Beck’s Depression Inventory; BPI, Brief Pain Inventory; CBT, cognitive behavioural therapy; CES-D, Center For Epidemiology Studies Depression Scale; CPI, Composite Pain Index; CPSS, Chronic Pain Self-efficacy Scale; DPD, Daily Pain Diary; Edu, education; FIQ, Fibromyalgia Impact Questionnaire; HAM-D, Hamilton Rating Scale For Depression; IRGL, impact of rheumatic diseases on health and lifestyle; MBSR, mindfulness-based stress reduction; MPQ, McGill Pain Index Questionnaire; NRS, numeric rating scale; PHQ, Patient Health Questionnaire; RDQ, Roland Disability Questionnaire; RMDQ, Roland-Morris Disability Questionnaire; SC, standard care; SCL-90, symptom checklist; SF, Short Form Health Survey; SIP, Sickness Impact Profile; TOPS, Treatment Outcomes in Pain Symptoms; VAS, Visual Analogue Scale; WL, wait-list.