Psychological therapies for the management of chronic pain (excluding headache) in adults

Amanda C de C Williams; Christopher Eccleston; Stephen Morley<sup>a</sup>

doi:10.1002/14651858.CD007407.pub3

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Figure 1

'Risk of bias' summary: review authors' judgements about each methodological quality item for each included study.

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Figure 2

'Risk of bias' graph: review authors' judgements about each methodological quality item presented as percentages across all included studies.

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Analysis 1.1

Comparison 1 Cognitive behavioural vs active control post‐treatment, Outcome 1 Pain.

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Analysis 1.2

Comparison 1 Cognitive behavioural vs active control post‐treatment, Outcome 2 Disability.

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Analysis 1.3

Comparison 1 Cognitive behavioural vs active control post‐treatment, Outcome 3 Mood.

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Analysis 1.4

Comparison 1 Cognitive behavioural vs active control post‐treatment, Outcome 4 Catastrophising.

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Analysis 2.1

Comparison 2 Cognitive behavioural vs active control follow‐up, Outcome 1 Pain.

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Analysis 2.2

Comparison 2 Cognitive behavioural vs active control follow‐up, Outcome 2 Disability.

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Analysis 2.3

Comparison 2 Cognitive behavioural vs active control follow‐up, Outcome 3 Mood.

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Analysis 2.4

Comparison 2 Cognitive behavioural vs active control follow‐up, Outcome 4 Catastrophising.

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Analysis 3.1

Comparison 3 Cognitive behavioural vs treatment as usual, Outcome 1 Pain.

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Analysis 3.2

Comparison 3 Cognitive behavioural vs treatment as usual, Outcome 2 Disability.

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Analysis 3.3

Comparison 3 Cognitive behavioural vs treatment as usual, Outcome 3 Mood.

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Analysis 3.4

Comparison 3 Cognitive behavioural vs treatment as usual, Outcome 4 Catastrophising.

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Analysis 4.1

Comparison 4 Cognitive behavioural vs treatment as usual follow‐up, Outcome 1 Pain.

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Analysis 4.2

Comparison 4 Cognitive behavioural vs treatment as usual follow‐up, Outcome 2 Disability.

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Analysis 4.3

Comparison 4 Cognitive behavioural vs treatment as usual follow‐up, Outcome 3 Mood.

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Analysis 4.4

Comparison 4 Cognitive behavioural vs treatment as usual follow‐up, Outcome 4 Catastrophising.

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Analysis 5.1

Comparison 5 Behavioural vs active control post‐treatment, Outcome 1 Pain.

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Analysis 5.2

Comparison 5 Behavioural vs active control post‐treatment, Outcome 2 Disability.

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Analysis 5.3

Comparison 5 Behavioural vs active control post‐treatment, Outcome 3 Mood.

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Analysis 5.4

Comparison 5 Behavioural vs active control post‐treatment, Outcome 4 Catastrophising.

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Analysis 6.1

Comparison 6 Behavioural vs active control follow‐up, Outcome 1 Pain.

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Analysis 6.2

Comparison 6 Behavioural vs active control follow‐up, Outcome 2 Disability.

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Analysis 6.3

Comparison 6 Behavioural vs active control follow‐up, Outcome 3 Mood.

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Analysis 6.4

Comparison 6 Behavioural vs active control follow‐up, Outcome 4 Catastrophising.

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Analysis 7.1

Comparison 7 Behavioural vs treatment as usual post‐treatment, Outcome 1 Pain.

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Analysis 7.2

Comparison 7 Behavioural vs treatment as usual post‐treatment, Outcome 2 Disability.

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Analysis 7.3

Comparison 7 Behavioural vs treatment as usual post‐treatment, Outcome 3 Mood.

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Analysis 7.4

Comparison 7 Behavioural vs treatment as usual post‐treatment, Outcome 4 Catastrophising.

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Analysis 8.1

Comparison 8 Behavioural vs treatment as usual follow‐up, Outcome 1 Pain.

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Analysis 8.2

Comparison 8 Behavioural vs treatment as usual follow‐up, Outcome 2 Disability.

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Analysis 8.3

Comparison 8 Behavioural vs treatment as usual follow‐up, Outcome 3 Mood.

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Comparison 1. Cognitive behavioural vs active control post‐treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	13	1258	Std. Mean Difference (IV, Random, 95% CI)	‐0.10 [‐0.24, 0.04]

2 Disability Show forest plot	12	1130	Std. Mean Difference (IV, Random, 95% CI)	‐0.19 [‐0.33, ‐0.05]

3 Mood Show forest plot	13	1256	Std. Mean Difference (IV, Random, 95% CI)	‐0.05 [‐0.19, 0.09]

4 Catastrophising Show forest plot	6	735	Std. Mean Difference (IV, Random, 95% CI)	‐0.18 [‐0.36, 0.00]

Comparison 1. Cognitive behavioural vs active control post‐treatment

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Comparison 2. Cognitive behavioural vs active control follow‐up

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	11	1261	Std. Mean Difference (IV, Random, 95% CI)	‐0.08 [‐0.23, 0.06]

2 Disability Show forest plot	12	1295	Std. Mean Difference (IV, Random, 95% CI)	‐0.15 [‐0.28, ‐0.02]

3 Mood Show forest plot	11	1261	Std. Mean Difference (IV, Random, 95% CI)	‐0.07 [‐0.18, 0.05]

4 Catastrophising Show forest plot	2	282	Std. Mean Difference (IV, Random, 95% CI)	0.06 [‐0.18, 0.29]

Comparison 2. Cognitive behavioural vs active control follow‐up

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Comparison 3. Cognitive behavioural vs treatment as usual

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	16	1148	Std. Mean Difference (IV, Random, 95% CI)	‐0.21 [‐0.37, ‐0.05]

2 Disability Show forest plot	15	1105	Std. Mean Difference (IV, Random, 95% CI)	‐0.26 [‐0.47, ‐0.04]

3 Mood Show forest plot	12	899	Std. Mean Difference (IV, Random, 95% CI)	‐0.38 [‐0.57, ‐0.18]

4 Catastrophising Show forest plot	5	308	Std. Mean Difference (IV, Random, 95% CI)	‐0.53 [‐0.76, ‐0.31]

Comparison 3. Cognitive behavioural vs treatment as usual

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Comparison 4. Cognitive behavioural vs treatment as usual follow‐up

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	7	635	Std. Mean Difference (IV, Random, 95% CI)	‐0.09 [‐0.25, 0.08]

2 Disability Show forest plot	6	450	Std. Mean Difference (IV, Random, 95% CI)	‐0.13 [‐0.51, 0.25]

3 Mood Show forest plot	7	637	Std. Mean Difference (IV, Random, 95% CI)	‐0.26 [‐0.51, ‐0.00]

4 Catastrophising Show forest plot	1		Std. Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 4. Cognitive behavioural vs treatment as usual follow‐up

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Comparison 5. Behavioural vs active control post‐treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	1		Std. Mean Difference (IV, Random, 95% CI)	Totals not selected

2 Disability Show forest plot	2	148	Std. Mean Difference (IV, Random, 95% CI)	‐0.26 [‐0.58, 0.07]

3 Mood Show forest plot	1		Std. Mean Difference (IV, Random, 95% CI)	Totals not selected

4 Catastrophising Show forest plot	2	146	Std. Mean Difference (IV, Random, 95% CI)	‐0.28 [‐0.60, 0.05]

Comparison 5. Behavioural vs active control post‐treatment

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Comparison 6. Behavioural vs active control follow‐up

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	1		Std. Mean Difference (IV, Random, 95% CI)	Totals not selected

2 Disability Show forest plot	2	144	Std. Mean Difference (IV, Random, 95% CI)	‐0.17 [‐0.50, 0.16]

3 Mood Show forest plot	1		Std. Mean Difference (IV, Random, 95% CI)	Totals not selected

4 Catastrophising Show forest plot	1		Std. Mean Difference (IV, Random, 95% CI)	Totals not selected

Comparison 6. Behavioural vs active control follow‐up

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Comparison 7. Behavioural vs treatment as usual post‐treatment

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	5	484	Std. Mean Difference (IV, Random, 95% CI)	‐0.27 [‐0.79, 0.24]

2 Disability Show forest plot	5	504	Std. Mean Difference (IV, Random, 95% CI)	‐0.41 [‐0.98, 0.16]

3 Mood Show forest plot	3	278	Std. Mean Difference (IV, Random, 95% CI)	‐0.53 [‐1.42, 0.35]

4 Catastrophising Show forest plot	3	269	Std. Mean Difference (IV, Random, 95% CI)	‐0.72 [‐1.43, ‐0.01]

Comparison 7. Behavioural vs treatment as usual post‐treatment

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Comparison 8. Behavioural vs treatment as usual follow‐up

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Pain Show forest plot	2	182	Std. Mean Difference (IV, Random, 95% CI)	‐0.03 [‐0.32, 0.26]

2 Disability Show forest plot	3	336	Std. Mean Difference (IV, Random, 95% CI)	‐0.54 [‐1.51, 0.44]

3 Mood Show forest plot	2	160	Std. Mean Difference (IV, Random, 95% CI)	‐0.65 [‐2.07, 0.77]

Comparison 8. Behavioural vs treatment as usual follow‐up

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