Characteristics of included studies and results
First author, Year | Intervention (I)/Intervention 2 (I2)/Control (C) | N | Population | Outcome measures analysed | Therapist qualifications | Treatment adherence | Results Mean (SD) | ||
Physical functioning | Pain intensity | Depression | |||||||
Alda, 201120 | CBT/SC | 113 | Fibromyalgia 18–65 years |
| Trained therapists from the Torrero Health Centre | Random sessions were audio-recorded and assessed by team members | FIQ: 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/WL | 91 | Fibromyalgia ≥18 years |
| Professional internship training programme at the UMass Medical Centre Stress Reduction Clinic | Information not provided | FIQ: 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/SC | 23 | Fibromyalgia 18–60 years |
| Information not provided | Information not provided | FIQ: 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/SC | 341 | Chronic low back pain 20–70 years |
| 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 group | RDQ (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/SC | 25 | Failed back surgery syndrome |
| Psychotherapist and osteopath physician who is board certified in neuromusculoskeletal medicine. Both teachers completed the MBSR Teacher Development Intensive (TDI) from the UMass Medical Center | Information not provided | RMDQ: 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/SC | 51 | Fibromyalgia 18–65 years |
| Physician trained in CBT techniques | Information not provided | VAS: 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/WL | 43 | Fibromyalgia 18–55 years |
| Psychologists trained in CBT | Information not provided | VAS: 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/SC | 55 | Gulf war illness |
| Information not provided | Information not provided | MPQ: 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/SC | 63 | Osteoarthritis of the knee ≥18 years |
| Psychologists with experience in cognitive-behavioural pain management group therapy; therapists received training in intervention and weekly supervision | Independent ratings of audiotapes of treatment sessions conducted | AIMS-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/SC | 43 | Rheumatoid arthritis) ≥20 years |
| Clinical psychologist trained in CBT and supervised by a behaviour therapist | Sessions tape recorded and reviewed by supervising behaviour therapist | IRGL-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/SC | 109 | Non-specific chronic pain 19 - 76 years |
| 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 integrity | Information not provided | SF-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 control | 101 | Fibromyalgia ≥18 years |
| Information not provided | Information not provided | FIQ: 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/SC | 47 | Temporomandibular disorders 18–65 years |
| Clinical psychologists and advanced doctoral students clinical psychology programme; therapists received individual and group training and weekly supervision by licensed psychologist on the team | Treatment sessions were recorded and the audiotapes were randomly reviewed using the Therapist Competency Rating form | CPI: 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/SC | 63 | Rheumatoid arthritis ≥18 years |
| Certified MBSR teachers from the Centre for Mindfulness at UMass Medical School | Information not provided | SCL90-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/WL | 69 | Any chronic pain condition ≥21 years |
| Information not provided | Information not provided | DPD: 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/WL | 112 | Fibromyalgia 18–70 years |
| University-level degrees in educational counselling; training in MBSR from the UMass Medical school and 7 years of experience teaching MBSR | Information not provided | CES-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/WL | 90 | Fibromyalgia ≥18 years |
| Licensed clinical psychologist who trained in MBSR at UMass Medical School | Information not provided | BDI: 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 control | 38 | Chronic musculoskeletal pain 19–59 years |
| Information not provided | Information not provided | CPSS: 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/SC | 104 | Chronic low back pain 18–65 years |
| Clinical psychologist or social worker trained in CBT | Observations by independent researcher of all active treatments via on-site visits, audio and video recordings | RMDQ (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/WL | 45 | Chronic low back pain 20–65 years |
| Clinical psychologists with previous supervised clinical experience with CBT treatment for chronic pain | Pretreatment and post-treatment analysis of therapists’ beliefs and confidence in treatment techniques | SIP: 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/SC | 60 | Fibromyalgia ≥18 years |
| Doctoral-level clinical psychologist with extensive experience in CBT with patients with fibromyalgia | Information not provided | CPSS: 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.