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Psychological Treatments for Chronic Pain in East and Southeast Asia: A Systematic Review

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Abstract

Background

Psychological treatments are recognised as generally effective for chronic pain. However, little is known about the evidence for psychological treatments for chronic pain in Asia.

Purpose

This study aimed (1) to identify all treatment outcome studies in the area of psychological approaches to chronic pain in adult populations of East Asia and Southeast Asia and (2) to evaluate the treatment types, the evidence for treatment outcomes and research design quality with regard to these studies.

Methods

We identified all psychologically based treatment outcome studies for chronic pain in East and Southeast Asia by searching CENTRAL, EMBASE, PsycINFO, MEDLINE (via Ovid), Global Health and Web of Science from the beginning of each abstracting service until December 2014 (week 4).

Results

Seventeen studies met inclusion criteria including a total of N = 1,890 participants. Four were randomised controlled trials (RCTs), five controlled clinical trials (CCTs) and eight cohort studies. Treatment outcomes included pain, disability, depression and anxiety. Overall, the studies included in this review showed small to medium within-group effect sizes for all four outcomes. A majority of the studies were rated as weak in design quality. Three RCTs were found to be of strong quality, one of moderate quality and only one CCT of moderate quality.

Conclusion

The current available literature on psychological treatments for chronic pain in East and Southeast Asia is generally small in scale, mostly preliminary and lags behind on some developments occurring in North America and Europe. Further development of treatment methods and research designs is warranted.

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Informed Consent Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Conflict of Interest

Su-Yin Yang, Lance McCracken and Rona Moss-Morris declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Health Psychology Section, Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 5th Floor Bermondsey Wing, Guy’s Campus, London, SE1 9RT, UK

    Su-Yin Yang, Lance M. McCracken & Rona Moss-Morris

  2. Pain Management Clinic, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Su-Yin Yang

Authors
  1. Su-Yin Yang
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  2. Lance M. McCracken
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  3. Rona Moss-Morris
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Corresponding author

Correspondence to Lance M. McCracken.

Appendices

Appendix 1

Search Strategy

Search Terms for Pain

  1. 1

    exp chronic pain/

  2. 2

    “chronic pain”.mp.

  3. 3

    exp fibromyalgia/

  4. 4

    “fibromyalgia”.mp.

  5. 5

    exp rheumatoid arthritis/

  6. 6

    (“arthritis” or “osteoarthritis”).mp.

  7. 7

    exp low back pain/

  8. 8

    “low back pain”.mp.

  9. 9

    exp musculoskeletal pain/ or exp myofascial pain/

  10. 10

    “musculoskeletal pain”.mp.

Search Terms for Psychological Treatment

  1. 11

    exp psychotherapy/

  2. 12

    “psychotherapy”.mp.

  3. 13

    exp cognitive therapy/

  4. 14

    “cognitive therapy”.mp.

  5. 15

    “cognitive behavio$r therapy”.mp.

  6. 16

    exp behavior therapy/

  7. 17

    “behavio$r therapy”.mp.

  8. 18

    (“acceptance and commitment therapy”).mp.

  9. 19

    “mindfulness”.mp.

  10. 20

    exp coping behavior/

  11. 21

    “coping skills”.mp.

  12. 22

    exp self care/

  13. 23

    “self management”.mp.

  14. 24

    exp psychoeducation/ or exp education/ or exp health education/

  15. 25

    “psychoeducation”.mp.

Search Terms for Countries in South-East Asia

  1. 26

    26 exp Asia/ or exp Southeast Asia/

  2. 27

    “Southeast Asia”.mp.

  3. 28

    “East Asia”.mp.

  4. 29

    “Singapore”.mp.

  5. 30

    “Singapore$”.mp.

  6. 31

    “Cambodia”.mp.

  7. 32

    “Cambodia$”.mp.

  8. 33

    “Thailand”.mp.

  9. 34

    “Thai$”.mp.

  10. 35

    “Indonesia”.mp.

  11. 36

    “Indonesia$”.mp.

  12. 37

    “Malaysia”.mp.

  13. 38

    “Malaysia$”.mp.

  14. 39

    (“Philippines” or “Filipino”).mp.

  15. 40

    “Laos”.mp.

  16. 41

    “Lao$”.mp.

  17. 42

    “Myanmar”.mp.

  18. 43

    “Myanm$”.mp.

  19. 44

    “Vietnam”.mp.

  20. 45

    “Vietnam$”.mp.

  21. 46

    “Brunei”.mp.

  22. 47

    “Brunei$”.mp.

  23. 48

    “East Timor”.mp.

  24. 49

    “East Timor$”.mp.

  25. 50

    “China”.mp.

  26. 51

    “Chinese”.mp.

  27. 52

    “Japan”.mp.

  28. 53

    “Japan$”.mp.

  29. 54

    “Hong Kong”.mp.

  30. 55

    “Macau”.mp.

  31. 56

    “Taiwan”.mp.

  32. 57

    “Taiwan$”.mp.

  33. 58

    “Mongolia”.mp.

  34. 59

    “Mongolia$”.mp.

  35. 60

    “Korea”.mp.

  36. 61

    “North Korea”.mp.

  37. 62

    “South Korea”.mp.

  38. 63

    “Korea$”.mp.

Appendix 2

Items Included in the Data Extraction Sheet

  1. 1.

    Study ID

  2. 2.

    Date of data extraction

  3. 3.

    Identification features of the study [author(s), article title, source (Journal, year, volume, pages, country of origin), institutional affiliation (first author)]

  4. 4.

    Study characteristics [sample size, population from which study was drawn, inclusion/exclusion criteria, recruitment procedures]

  5. 5.

    Characteristics of participants at intervention commencement [age, ethnicity, sex, diagnosis, pain duration, % agreed to participate, number of participants randomised in each condition (for randomised trials), intervention and control groups comparable at baseline, blinding]

  6. 6.

    Methods [design, type of study, objectives specified in Methods section]

  7. 7.

    Interventions [number of conditions (including control condition), description of intervention, duration of intervention, who delivers the intervention, what special training was provided for treatment delivery providers, was the intervention manualised]

  8. 8.

    Outcomes, outcome measures [measures at baseline, primary outcome (pain, disability, depression, anxiety), measures at end of treatment]

  9. 9.

    Reported outcomes [when and how the measurement was conducted, follow-up period, measures at follow-up, statistical technique used, attrition rate and whether attrition was adequately dealt with]

  10. 10.

    Results [main findings]

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Yang, SY., McCracken, L.M. & Moss-Morris, R. Psychological Treatments for Chronic Pain in East and Southeast Asia: A Systematic Review. Int.J. Behav. Med. 23, 473–484 (2016). https://doi.org/10.1007/s12529-015-9481-3

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  • DOI: https://doi.org/10.1007/s12529-015-9481-3

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