An umbrella review of the literature on the effectiveness of psychological interventions for pain reduction, 2017, Markozannes et al.

An umbrella review of the literature on the effectiveness of psychological interventions for pain reduction

https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-017-0200-5

Abstract
Background
Psychological interventions are widely implemented for pain management and treatment, but their reported effectiveness shows considerable variation and there is elevated likelihood for bias.

Methods
We summarized the strength of evidence and extent of potential biases in the published literature of psychological interventions for pain treatment using a range of criteria, including the statistical significance of the random effects summary estimate and of the largest study of each meta-analysis, number of participants, 95% prediction intervals, between-study heterogeneity, small-study effects and excess significance bias.

Results
Thirty-eight publications were identified, investigating 150 associations between several psychological interventions and 29 different types of pain. Of the 141 associations based on only randomized controlled trials, none presented strong or highly suggestive evidence by satisfying all the aforementioned criteria. The effect of psychological interventions on reducing cancer pain severity, pain in patients with arthritis, osteoarthritis, rheumatoid arthritis, breast cancer, fibromyalgia, irritable bowel syndrome, self-reported needle-related pain in children/adolescents or with chronic musculoskeletal pain, chronic non-headache pain and chronic pain in general were supported by suggestive evidence.

Conclusions
The present findings reveal the lack of strong supporting empirical evidence for the effectiveness of psychological treatments for pain management and highlight the need to further evaluate the established approach of psychological interventions to ameliorate pain.

 

Nice find @Trish
It's open access

Umbrella review?

 

Crossposted with Hutan.

Just came across this study from 4 years ago, and thought it was interesting in the light of ongoing problems with studies of psychological treatments for subjectively assessed symptoms such as pain and fatigue.

The authors point to lots of problems with systematic reviews including small studies, marginal statistical significance, poor quality studies included, etc.

 

My interest in this was not the individual outcomes in the systematic reviews they looked at but their recognition of the major flaws in all the systematic reviews. They were not drawing conclusions about particular therapies for particular pain conditions, but about the overall problem that none of the evidence really stood up to scrutiny for all sorts of reasons that systematic reviews tend to ignore.