Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2019 Feb;22(1):26-35.
doi: 10.1136/ebmental-2018-300062.

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

Eve-Ling Khoo  1   2 , Rebecca Small  1   3 , Wei Cheng  1 , Taylor Hatchard  4 , Brittany Glynn  1 , Danielle B Rice  1   5 , Becky Skidmore  6 , Samantha Kenny  1   7 , Brian Hutton  1 , Patricia A Poulin  1   8   9
Affiliations
Meta-Analysis

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

Eve-Ling Khoo et al. Evid Based Ment Health. 2019 Feb.

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.

Keywords: chronic pain; meta-analysis; cognitive-behavioral therapy; mindfulness-based stress reduction; randomized controlled trials.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Study selection. RCT, randomised controlled trial.
Figure 2
Figure 2
Network diagrams by endpoint. Panels (A)–(C) present networks diagrams of the evidence analysed for the three endpoints. Treatment nodes for each network were sized to proportionately reflect the numbers of patients randomised to each intervention included in the network, while the thickness of the edges joining the treatment nodes was sized to proportionately reflect the number of studies informing each treatment comparison. Note: One study was a three-armed study comparing MBSR (n=116) and CBT (n=112) and control (n=113). CBT, cognitive behavioural therapy; MBSR, mindfulness-based stress reduction.
Figure 3
Figure 3
Summary of findings from RE NMA—SMD with 95% CrI. *Number of unconstrained data points=number of arms with reported mean change+number of arms with reported preintervention and postintervention data. CBT, cognitive behavioral therapy; CrI, credible interval; MBSR, mindfulness-based stress reduction; SMD, standardised mean difference.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. IASP. Unrelieved pain is a major global healthcare problem. 2004.
    1. Morley S, Williams A, Hussain S. Estimating the clinical effectiveness of cognitive behavioural therapy in the clinic: evaluation of a CBT informed pain management programme. Pain 2008;137:670–80. 10.1016/j.pain.2008.02.025 - DOI - PubMed
    1. Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain: efficacy, innovations, and directions for research. Am Psychol 2014;69:153–66. 10.1037/a0035747 - DOI - PubMed
    1. Kabat-Zinn J, Hanh TN. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. Delta, 2009.
    1. Hatchard T, Lepage C, Hutton B, et al. . Comparative evaluation of group-based mindfulness-based stress reduction and cognitive behavioral therapy for the treatment and management of chronic pain disorders: protocol for a systematic review and meta-analysis with indirect comparisons. Syst Rev 2014;3:134. 10.1186/2046-4053-3-134 - DOI - PMC - PubMed

MeSH terms

Grants and funding