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Braunwalder C, Muller R, Glisic M, et al. Are positive psychology interventions efficacious in chronic pain treatment? A systematic review and meta-analysis of randomized controlled trials. Pain Med. 2021 Aug 4. pii: 6339592. doi: 10.1093/pm/pnab247. (Systematic review)
Abstract

OBJECTIVE: Although positive psychology interventions are increasingly popular in chronic pain treatment their efficacy is still unclear. The objective is to summarize evidence on the effect of positive psychology interventions (PPIs) on pain, physical functioning, and emotional functioning in adults with chronic pain.

METHODS: Four electronic databases and additional references were searched for randomized controlled trials published between 1990 and 2020. Findings from included studies were qualitatively and quantitatively synthesized, and study quality was assessed for risk of bias. A random effects meta-analysis model was applied for outcomes with more than four findings.

RESULTS: Of 16 included randomized controlled trials, almost half delivered positive psychology interventions as self-help online interventions, and half conducted guided face-to-face interventions which lasted mostly eight weeks. Results from meta-analysis showed beneficial effects of positive psychology interventions compared to the control group on pain intensity and emotional functioning (i.e., less depressive symptoms, pain catastrophizing, negative affect; more positive affect) post-intervention. At 3-month follow-up, beneficial effects were maintained for depressive symptoms and positive and negative affect, but not for pain catastrophizing. However, the evidence on the long-term efficacy of PPIs and the efficacy of PPIs on physical functioning remains limited.

CONCLUSION: This review supports the notion that positive psychology interventions are beneficial to chronic pain treatment, although further, high quality research is needed to support this conclusion.

Ratings
Discipline Area Score
Physician 5 / 7
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Comments from MORE raters

Physician rater

Pain is a complex medical disorder and its effective treatment should include multitude modalities. This article points out the clinical benefits of positive psychologic interventions, clearly an important although not always readily available modality.

Physician rater

Embase was omitted in the search as were articles written in a language other than English.

Physician rater

Old news, rehashed.

Physician rater

This meta-analysis, like many in the field of chronic pain, suffers from the low numbers of studies sampled because of the inadequate design of the studies from the large remainder not selected. There is also great heterogeneity of the diagnoses of the patients selected, which make it difficult to generalise the effects of treatment. Chronic pain is not a distinct entity; it varies in quality and intensity from patient to patient and differs in its effects according to the diagnosis of the condition from which the patient suffers. It is impossible to draw any useful conclusions from a study of this nature for these reasons.
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