"Because this analysis was both more inclusive and more conservative than previous reviews, we have the best evidence to date that these interventions are helpful," said psychologist and review lead author Robert Kerns, Ph.D., of the Veterans Affairs Connecticut Healthcare System.
To evaluate the effects of psychological interventions on pain-related outcomes, Kerns and his team gathered data from 22 randomized trials published between 1982 and 2003. The studies were not limited to any one psychological approach. Included in the review were behavioural and cognitive-behavioural techniques; self-regulatory techniques such as hypnosis, biofeedback, and relaxation; and supportive counselling.
In the broadest analysis, psychological interventions - alone or as part of a multidisciplinary approach - proved to be superior to waiting lists or standard treatments on the entire range of pain-related outcomes. When the researchers analyzed specific outcomes, they found that the largest and most consistent effect was a reduction in pain intensity.
This was somewhat surprising, Kerns said, because when psychologists first began developing interventions for chronic pain several decades ago, the goal was not to reduce pain but to help patients live with their pain more successfully. "However, a growing body of knowledge suggests that these interventions are actually having a primary effect on people's experience of pain," he said. The review found that psychological interventions also yielded improvements in health-related quality of life, work-related disability, interference of pain with daily living and depression.
Not all treatments were equally effective. Cognitive-behavioural and self-regulatory treatments seemed to yield the greatest effects, particularly when compared to waiting list control groups.
MEDICA.de; Source: Center for the Advancement of Health