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Purpose <p>Chronic musculoskeletal disorders cause persistent pain and depression, impacting the quality of life. While cognitive behavioral therapy (CBT) is widely used for symptom management, the efficacy of remote CBT remains unclear. This study evaluates its effectiveness in improving pain and depression.</p> Methods <p>A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted using Review Manager (v5.4). CENTRAL, CINAHL, EMBASE, LILACS, MEDLINE, PSYNDEX, and PsycINFO were searched until December 2024. Random effects models estimated effect sizes, with sensitivity analyses conducted to assess bias and sample size.</p> Results <p>Eighteen RCTs (n = 5446) showed that remote CBT reduced pain (SMD − 0.02, 95% CI − 0.008 to − 0.004) and improved depression (SMD − 0.04, 95% CI − 0.10 to − 0.03) at 12&#xa0;weeks. Evidence certainty ranged from low to moderate. No significant association was found between dropout rates and adverse events. Remote CBT, including mobile apps and interactive voice response, showed similar efficacy to in-person CBT. Internet-based and telecare CBT had superior depression outcomes at 12&#xa0;weeks.</p> Conclusions <p>Remote CBT, including mobile apps and telecare, can be an effective alternative to in-person CBT for chronic musculoskeletal disorders, particularly in improving depression symptoms within 12&#xa0;weeks.</p>

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Cognitive Behavioral Therapy for Patients with Chronic Musculoskeletal Disorders: A Systematic Review and Meta-analysis

  • 期刊论文

  • 发表日期：

    2025年12月19日

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  • Hsuan-Wei Liu,
  • Tsung-Lin Tsai

摘要

Purpose

Chronic musculoskeletal disorders cause persistent pain and depression, impacting the quality of life. While cognitive behavioral therapy (CBT) is widely used for symptom management, the efficacy of remote CBT remains unclear. This study evaluates its effectiveness in improving pain and depression.

Methods

A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted using Review Manager (v5.4). CENTRAL, CINAHL, EMBASE, LILACS, MEDLINE, PSYNDEX, and PsycINFO were searched until December 2024. Random effects models estimated effect sizes, with sensitivity analyses conducted to assess bias and sample size.

Results

Eighteen RCTs (n = 5446) showed that remote CBT reduced pain (SMD − 0.02, 95% CI − 0.008 to − 0.004) and improved depression (SMD − 0.04, 95% CI − 0.10 to − 0.03) at 12 weeks. Evidence certainty ranged from low to moderate. No significant association was found between dropout rates and adverse events. Remote CBT, including mobile apps and interactive voice response, showed similar efficacy to in-person CBT. Internet-based and telecare CBT had superior depression outcomes at 12 weeks.

Conclusions

Remote CBT, including mobile apps and telecare, can be an effective alternative to in-person CBT for chronic musculoskeletal disorders, particularly in improving depression symptoms within 12 weeks.