The Effectiveness of Cognitive-Behavioral Therapy by Group Method on The Amount of Stress, Anxiety and Depression and Pain Intensity of Patients with Chronic Musculoskeletal Pain

Background and Aim: One of the most important medical problems in the whole world is chronic pain, which affects millions of people every year and they are not provided with proper treatment. Research shows that one of the consequences of chronic pain is emotional reactions such as anxiety, depression, and stress that occur due to the long-term effects of pain. Therefore, the aim of the present study is to determine the effectiveness of cognitive-behavioral therapy on the mental health and pain intensity level of patients with chronic pain. Materials and Methods: In this semi-experimental study, 126 patients with chronic musculoskeletal pain and having entry and exit criteria from physiotherapy centers under the supervision of Shoushtar Medical Sciences Faculty were randomly divided into two groups of 63 intervention and control. The intervention group received the intervention based on cognitive behavioral therapy for three months and 12 educational sessions. The patients of both groups completed the data collection tool, which included the numerical pain questionnaire (VAS) and the stress, anxiety and depression level questionnaire DASS21, before the intervention and one week after the completion of the educational intervention. To analyze the data, descriptive and parametric tests (paired t and independent t), Pearson correlation and covariance analysis were used using SPSS software. Results: The average age of the participants was (46.12±27.16) years. The effectiveness of cognitive-behavioral therapy was associated with a significant reduction in stress, anxiety, and depression levels (P<0.001) only in the intervention group, and this reduction was seen in the levels of stress (P=0.032), anxiety (P=0.030), and depression (P=0.015) compared to the control group. A significant reduction in pain intensity was observed in both groups (P<0.001). However, this reduction in the intervention group was not statistically different from the control group (P>0.05). Also, there was no significant correlation between the levels of stress, anxiety, and depression and pain disability (P<0.05). Conclusion: The findings of the present study emphasize the importance of using cognitive behavioral therapy in a group setting to treat stress, anxiety, depression, and pain intensity in patients with chronic musculoskeletal pain.