The Effects of Psychological Interventions on Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis

Simona Racaru, Jackie Sturt, Aycan Celik

Research output: Contribution to journalReview articlepeer-review

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Abstract

Abstract Background: Psychological interventions are effective at ameliorating the experience of pain in conditions such as rheumatoid arthritis and chronic back pain. However, their effect on diabetic peripheral neuropathy (DPN) pain has yet to be established. Aim: To assess the effectiveness of psychological interventions on pain and related outcomes in adults with DPN. Methods: Medline, Embase, PsychInfo, and CINAHL databases together with grey literature and trial registers were searched. A meta-analysis and narrative synthesis of included studies were undertaken. Results: Nine studies were selected from 1610 citations. At short-term follow-up psychological therapies showed a large effect on pain severity (SMD= -0.94, 95%CI[-1.50, -0.37], p=.001) a small effect on pain interference (SMD= -0.39, 95%CI[-0.73, -0.05], p=.02), and a moderate effect on depressive symptoms (SMD= -0.58, 95%CI[-0.95, -0.21], p=.002). Quality of life significantly improved in experimental subjects, (MD= -2.35, 95%CI[-3.99, -0.71], p=.005). At medium-term follow-up there was a large effect on pain severity (SMD= -1.26, 95%CI[-1.76, -0.77], p< .00001) and on pain interference (SMD= -0.91, 95%CI[-1.61, -0.21], p=.01) and a moderate effect on depressive symptoms (SMD= -0.76, 95%CI[-1.48, -0.05], p=.04). At long-term follow-up, improvements in pain interference, mood and self-care behaviors were reported. Conclusions. Psychological interventions can help to reduce pain levels and depressive symptoms and improve QoL in adults with DPN. These findings demonstrate that relationships between pain and perceived control among other groups who experience chronic pain may also be replicated in the DPN population. This is an important outcome that can guide further research and associated service developments.
Original languageEnglish
JournalPain Manag Nurs
Publication statusAccepted/In press - 12 Dec 2020

Keywords

  • Psychological Interventions
  • diabetic peripheral neuropathy
  • diabetes, pain
  • quality of life
  • systematic review

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