Cognitive behavior therapy significantly reduced depression and anxiety in chronic pain patients

June 15, 2017, European League Against Rheumatism

The results of a study presented today at the Annual European Congress of Rheumatology (EULAR) 2017 has shown that Acceptance and Commitment Therapy, a form of cognitive behavioural therapy (CBT) that focuses on psychological flexibility and behaviour change, provided a significant reduction in self-reported depression and anxiety among patients participating in a pain rehabilitation programme.

This treatment also resulted in significant increases in self-efficacy, activity engagement and pain acceptance.

To assess the potential benefits of an 8-week programme of group Acceptance and Commitment Therapy (ACT) in people with , measures of pain acceptance and activity engagement were taken using the Chronic Pain Acceptance Questionnaire. Measures of psychological distress using the Hospital Anxiety and Depression Scale and self-efficacy were also taken at assessment, on the final day of the programme, and at the follow up six-month review.

For those with scores at all three time points, there were statistically significant improvements in all parameters between baseline and at six-months follow-up, including the change in mean score of , , self-efficacy, activity engagement and pain willingness (p<0.001).

"To further validate the role of ACT in the treatment of chronic pain, specifically in a rheumatology context, a randomised controlled clinical trial that includes measures of physical and social functioning within a Rheumatology service would be desirable," said lead author Dr. Noirin Nealon Lennox from Ulster University in Northern Ireland.

ACT is a form of CBT that includes a specific therapeutic process referred to as "psychological flexibility". ACT focuses on behaviour change consistent with patients' core values rather than targeting symptom reduction alone. Evidence for this approach to the treatment of chronic pain has been mounting since the mid 2000's. A previous systematic review had concluded that ACT is efficacious for enhancing physical function and decreasing distress among adults with chronic pain attending a pain rehabilitation programme.

In this study, patients were referred into the ACT programme by three consultant rheumatologists over a five-year period. Over one hundred patients' outcome measures were available for a retrospective analysis.

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