Improve Anxiety and Depression in Iranian Chronic Pain Patients with Mindfulness
By John M. de Castro, Ph.D.
“mindful meditation can help ease psychological stresses like anxiety, depression, and pain.” – Julie Corliss
We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.
There is an accumulating volume of research findings to demonstrate that mindfulness practices, in general, are effective in treating pain. Chronic pain patients tend to also suffer from anxiety and depression and mindfulness has been shown to improve anxiety and depression. A lot of research has been done on various psychological treatments for chronic pain and its associated anxiety and depression. So, it makes sense to step back and take a look at what has been learned.
In today’s Research News article “Psychological interventions for depression and anxiety: a systematic review and meta-analysis of Iranian chronic pain trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7420174/) Jandaghi and colleagues review, summarize and perform a meta-analysis on treatments for chronic pain and its associated anxiety and depression in Iranian patients. They identified 30 randomized controlled trials with a total of 1021 participants.
They report that the published randomized controlled trials found that psychological interventions in general improve anxiety and depression in patients with chronic pain and these effects persist for at least several months. On average mindfulness-based therapies produced superior results to Cognitive Behavioral and other therapeutic approaches; producing greater relief of anxiety and depression.
Thus, the accumulated findings suggest that psychological treatments and especially mindfulness-based therapies are safe and effective treatment for anxiety and depression in chronic pain patients. This is important not only for the psychological well-being of the patients but also for their pain as anxiety and depression can amplify the levels of experienced pain in the patients.
So, improve anxiety and depression in Iranian chronic pain patients with mindfulness.
“Mindfulness exercises help people to focus their mind and body in the moment without judgment. . . Being able to focus on relaxing the body, noticing the breath and body sensations as being there just as they are, can help manage pain, as well as reduce depression and anxiety symptoms.” – Mayo Clinic
CMCS – Center for Mindfulness and Contemplative Studies
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Jandaghi, G., Firoozi, M., & Zia-Tohidi, A. (2020). Psychological interventions for depression and anxiety: a systematic review and meta-analysis of Iranian chronic pain trials. Health promotion perspectives, 10(3), 180–191. https://doi.org/10.34172/hpp.2020.31
Background: Chronic pain is commonly associated with anxiety and depression, making it more challenging to be managed. Psychological interventions are suggested for such complicated issues which are well evident in the United States and Europe. However, generalizing the evidence to Iranian population – as a Middle Eastern society – might be questionable. We aimed to synthesize our evidence on the effectiveness of these interventions among Iranian populations.
Methods: This was a systematic review and meta-analysis. Persian and English literature were searched through Iran-doc, Elm-net, and PubMed until March 2019 using the following terms (or its Persian synonyms): chronic pain; persistent pain; chronic fatigue; fibromyalgia; neuropath*; LBP; irritable bowel; CFS; psycho*; cogniti*; acceptance; meaning; mindfulness; relaxation; biopsychosocial; rehabilitation; educat*. Eligible trials were randomized trials that evaluated the effectiveness of psychological interventions on Iranian adults with chronic pain. No setting restriction was considered. Risk of bias for each trial was assessed, and the random-effect model was used to pool summary effect across trials.
Results: In all 30 eligible RCTs, the risk of bias for randomization was low except for one study. The pooled standardized mean difference (SMD) for depression and anxiety were 1.33 (95%CI: -1.42 to -0.68) and 1.25 (95% CI: -1.55 to -0.96), respectively.
Conclusion: This study suggests that psychological interventions are highly effective in reducing depression and anxiety in Iranian patients with chronic pain, compared to what observed in the U.S. and European studies. However, there are still some methodological issues to be addressed. Future research should focus on high-quality trials with considerations on the methodological issues reported in the present study.