The Effectiveness of Mindfulness-Based Interventions on Anxiety and Depression among Patients with Chronic Pain: A Systematic Review and Meta-Analysis

Background: Chronic pain is a debilitating condition frequently accompanied by significant psychological distress, notably anxiety and depression. Mindfulness-Based Interventions (MBIs) are widely employed as non-pharmacological therapies. This systematic review and meta-analysis aimed to precisely quantify the efficacy of MBIs in reducing symptoms of anxiety and depression among adult patients with various chronic pain syndromes.Methods: This review adhered to the PRISMA ۲۰۲۰ and Cochrane guidelines. A systematic search was performed across PubMed, Embase, Web of Science, and PsycINFO up to September ۲۰۲۳ for Randomized Controlled Trials (RCTs) comparing MBIs against any control for chronic pain patients. The Cochrane Risk of Bias tool ۲.۰ (RoB ۲) was used for quality appraisal. Data were synthesized using a random-effects model, calculating the Standardized Mean Difference (SMD) and ۹۵% Confidence Intervals (CI). Heterogeneity was assessed using the I^۲ statistic, and publication bias was assessed via Egger’s test.Results: Twenty-five RCTs involving ۲,۴۵۰ participants were included. The meta-analysis demonstrated a moderate, statistically significant reduction in anxiety scores for MBI groups compared to controls (SMD = -۰.۴۸; ۹۵% CI: -۰.۶۵ to -۰.۳۱; p < ۰.۰۰۱). A similar, robust effect was found for depression (SMD = -۰.۵۵; ۹۵% CI: -۰.۷۰ to -۰.۴۰; p < ۰.۰۰۱). Substantial heterogeneity was present for both outcomes (I^۲ ≈ ۷۰%). Subgroup analysis confirmed that effect sizes were significantly larger when MBIs were compared to inactive controls (e.g., waitlist) than to active controls (e.g., CBT or psychoeducation), suggesting a role for non-specific therapeutic factors. Egger’s test indicated potential publication bias.Conclusion: MBIs offer a moderately effective psychological treatment for mitigating anxiety and depression symptoms in the chronic pain population. These findings support the integration of structured MBIs into multidisciplinary pain management protocols. Future research should prioritize high-quality RCTs comparing MBIs directly against established active psychological therapies to isolate the specific benefits of mindfulness.

کلیدواژه ها:

Mindfulness-Based Interventions ، Chronic Pain ، Anxiety ، Depression ، Systematic Review ، Meta-Analysis