Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Psychological Interventions & Chronic Pain Reduction

JAMA Intern Med; ePub 2018 May 7; Niknejad, et al

Among older adults with chronic pain, psychological interventions have a small but statistically significant benefit for reducing pain and catastrophizing beliefs and improving pain self-efficacy for managing pain. This according to a recent systematic review and meta-analysis that sought to determine the efficacy of psychological interventions in older adults with chronic pain and whether treatment effects vary by participant, intervention, and study characteristics. Pain intensity with the primary outcome; secondary outcomes included pain interference, depressive symptoms, anxiety, catastrophizing beliefs, self-efficacy for managing pain, physical function, and physical health. Among the details:

  • 22 studies with 2,608 participants (median aged 71.9 years; 69% women) were analyzed.
  • Psychological interventions that used cognitive behavioral therapy (CBT) modalities were associated with statistically significant benefits in terms of reduced pain and catastrophizing beliefs as well as improved self-efficacy for managing pain.
  • Benefits were small at the time of treatment completion.
  • There was evidence of effects persisting beyond the posttreatment assessment (6 months) only for pain.


Niknejad B, Bolier R, Henderson CR, et al. Association between psychological interventions and chronic pain outcomes in older adults. A systematic review and meta-analysis. [Published online ahead of print May 7, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2018.0756.