Efficacy of videoconference group Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD) for chronic low back pain (CLBP) plus comorbid depressive symptoms: A randomized controlled trial (IMPACT study).
Por:
Sanabria JP, Colomer A, Borràs X, Castaño-Asins JR, McCracken LM, Montero J, Pérez A, Edo S, Sanz A, Feliu A and Luciano JV
Publicada:
1 ago 2023
Ahead of Print:
25 abr 2023
Resumen:
This study examined the efficacy of adding a remote, synchronous, group, videoconference-based form of Acceptance and Commitment Therapy (ACT) or Behavioral Activation Therapy for Depression (BATD) to treatment-as-usual (TAU) in 234 patients with chronic low back pain (CLBP) plus comorbid depressive symptoms. Participants were randomly assigned to ACT, BATD, or TAU. Compared to TAU, ACT produced a significant reduction in pain interference at post-treatment (d = 0.64) and at follow-up (d = 0.73). BATD was only superior to TAU at follow-up (d = 0.66). A significant reduction in pain catastrophizing was reported by patients assigned to ACT and BATD at post-treatment (d = 0.45 and d = 0.59, respectively) and at follow-up (d = 0.59, in both) compared to TAU. Stress was significantly reduced at post treatment by ACT in comparison to TAU (d = 0.69). No significant between-group differences were found in depressive or anxiety symptoms. Clinically relevant NNT values for reduction in pain interference were obtained at post-treatment (ACT vs TAU = 4) and at follow-up (ACT vs TAU = 3; BATD vs TAU = 5). In both active therapies, improvements in pain interference at follow-up were significantly related to improvements at post-treatment in psychological flexibility. These findings suggest that new forms of Cognitive Behavioral Therapy (CBT) are clinically useful in improving pain interference and pain catastrophizing. Further research on evidence-based change processes is required to understand the therapeutic needs of patients with chronic pain and comorbid conditions. TRIAL NUMBER: NCT04140838 PERSPECTIVE: Group videoconference-based ACT and BATD showed greater efficacy than TAU for reducing pain interference and pain catastrophizing in patients with CLBP plus clinically relevant depression. Psychological flexibility appeared to be the main contributor to treatment effects for both ACT and BATD.
Filiaciones:
Sanabria JP:
Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
Colomer A:
Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
Borràs X:
Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
Castaño-Asins JR:
Parc de Salut MAR, Barcelona, Spain
McCracken LM:
Psychology Department, Uppsala University, Uppsala, Sweden
Montero J:
Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK
Pérez A:
Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
Institute of Health Research of Aragon (IIS Aragon), Miguel Servet University Hospital, Zaragoza, Spain
Edo S:
Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
Sanz A:
Department of Basic, Developmental and Educational Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
Feliu A:
Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
Department of Clinical and Health Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
Luciano JV:
Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
Department of Clinical and Health Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain. Electronic address:
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