The following is a summary of “Sudden gains in depression and anxiety during an online pain management programme for chronic pain,” published in the May 2024 issue of Pain by Bisby et al.

Before this study, the a link between sudden symptom improvement (“sudden gains”) in online pain management programs and better overall outcomes for patients with chronic pain suffering from depression and anxiety.

Researchers conducted a retrospective study examining sudden symptom improvements in depression or anxiety that occurred during online pain programs for chronic pain and if these improvements predicted better outcomes.

They analyzed data from a published randomized controlled trial (n=338), comparing sudden improvements and treatment results among three therapist guidance levels during the program: weekly, optional, and self-guided.

The results showed comparable rates of sudden improvements in depression (22%) and anxiety (24%) throughout treatment, with the majority occurring between Weeks 1 and 2. Therapist guidance didn’t impact sudden improvements; higher initial symptom severity consistently predicted sudden gain status. Treatment outcomes for depression or anxiety symptoms didn’t significantly differ between those who experienced sudden gains and those who didn’t across therapist guidance conditions.

Investigators concluded that sudden symptom improvements in online pain programs for chronic pain did not predict better outcomes for depression or anxiety in this study.

Source: onlinelibrary.wiley.com/doi/full/10.1002/ejp.2280