Comparison of cognitive behavioral and mindfulness meditation interventions on adaptation to rheumatoid arthritis for patients with and without history of recurrent depression.

Abstract

This research examined whether cognitive behavioral therapy and mindfulness interventions that target responses to chronic stress, pain, and depression reduce pain and improve the quality of everyday life for adults with rheumatoid arthritis (RA). The 144 RA participants were clustered into groups of 6-10 participants and randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P); mindfulness meditation and emotion regulation therapy (M); or education-only group (E), which served as an attention placebo control. The authors took a multimethod approach, employing daily diaries and laboratory assessment of pain and mitogen-stimulated levels of interleukin-6 (IL-6), a proinflammatory cytokine. Participants receiving P showed the greatest Pre to Post improvement in self-reported pain control and reductions in the IL-6; both P and M groups showed more improvement in coping efficacy than did the E group. The relative value of the treatments varied as a function of depression history. RA patients with recurrent depression benefited most from M across several measures, including negative and positive affect and physicians' ratings of joint tenderness, indicating that the emotion regulation aspects of that treatment were most beneficial to those with chronic depressive features.

Mindfulness Meditation for Chronic Pain: A Systematic Review

“…The median short-term follow-up time was eight weeks (range 4-12 weeks). Figure 3.3 shows a positive effect of meditation on pain from 0-12 weeks in 17 studies (Brown and Jones, 2013;Cash et al, 2015;Cathcart et al, 2014;Esmer et al, 2010;Morone, Greco, and Weiner, 2008;Omidi and Zargar, 2014;Plews-Ogan et al, 2005;Teixeira, 2010;Wells et al, 2014;Zautra et al, 2008;Parra-Delgado and LatorrePostigo, 2013;Rahmani and Talepasand, 2015;Gaylord et al, 2011;Ljotsson, Falk, et al, 2010), which was statistically significant in five studies Omidi and Zargar, 2014;Wells et al, 2014;Rahmani and Talepasand, 2015;Gaylord et al, 2011). The pooled analysis of all 24 RCTs showed a significant positive effect (SMD 0.27; CI 0.04, 0.50; 24 RCTs; I 2 64.6%).…”

“…Seven studies obtained a "good" quality rating Fogarty et al, 2015;Ljotsson, Falk, et al, 2010;Parra-Delgado and Latorre-Postigo, 2013;Zautra et al, 2008). Ten studies were judged to be of fair quality, primarily due to being unclear in some aspects of the methods (Cash et al, 2015;Davis and Zautra, 2013;Day et al, 2014;Dowd et al, 2015;Gaylord et al, 2011;la Cour and Petersen, 2015;Morone, Greco, and Weiner, 2008;Wells et al, 2014).…”

“…Pain scales and comparators varied from study to study (Astin et al, 2000;Brown and Jones, 2013;Cash et al, 2015;Cathcart et al, 2014;Davis and Zautra, 2013;Day et al, 2014;Dowd et al, 2015;Esmer et al, 2010;la Cour and Petersen, 2015;Meize-Grochowski et al, 2015;Morone, Greco, and Weiner, 2008;Morone et al, 2009;Omidi and Zargar, 2014;Plews-Ogan et al, 2005;Teixeira, 2010;Wells et al, 2014;Zautra et al, 2008;Parra-Delgado and Latorre-Postigo, 2013;Rahmani and Talepasand, 2015;Gaylord et al, 2011;Ljotsson, Falk, et al, 2010). The median follow-up time was 12 weeks, with a range of four to 60 weeks.…”

“…Nonsignificance persisted when poor quality studies were dropped from analysis (SMD 0.11; CI −0.10, 0.32; 6 RCTs; I 2 0%; not displayed). Eight RCTs examined the effect of mindfulness meditation on pain compared with education or support groups Davis and Zautra, 2013;Dowd et al, 2015;Morone et al, 2009;Gaylord et al, 2011;Ljotsson, Falk, et al, 2010;Zautra et al, 2008) (see Figure 3.7). The effect of meditation was significant in three of these studies, and not significant when studies were pooled (SMD 0.19; CI −0.11, 0.49; 8 RCTs; I 2 63.9%) Gaylord et al, 2011;Ljotsson, Falk, et al, 2010).…”

“…Ten RCTs measured depression outcomes Gaylord et al, 2011;la Cour and Petersen, 2015;Ljotsson, Falk, et al, 2010;MeizeGrochowski et al, 2015;Parra-Delgado and Latorre-Postigo, 2013;Wells et al, 2014;Zautra et al, 2008). Overall, meditation significantly reduced depression (SMD 0.17; CI 0.03, 0.31; 10 RCTs; I 2 0%).…”