Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: a systematic review and meta-analysis

Abstract The co-occurrence of central sensitization syndromes (CSS) and post-traumatic symptoms (PTSS) or post-traumatic stress disorder (PTSD) exacerbates impairment, and treatment is unsatisfactory in many cases. This systematic review and meta-analysis examined the effectiveness of psychological...

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Main Authors: Coralie Maire, Ana I. Sánchez, José M. Ventura-Lucena, Elena Miró, M. Pilar Martínez
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-025-16074-6
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author Coralie Maire
Ana I. Sánchez
José M. Ventura-Lucena
Elena Miró
M. Pilar Martínez
author_facet Coralie Maire
Ana I. Sánchez
José M. Ventura-Lucena
Elena Miró
M. Pilar Martínez
author_sort Coralie Maire
collection DOAJ
description Abstract The co-occurrence of central sensitization syndromes (CSS) and post-traumatic symptoms (PTSS) or post-traumatic stress disorder (PTSD) exacerbates impairment, and treatment is unsatisfactory in many cases. This systematic review and meta-analysis examined the effectiveness of psychological therapy in individuals with CSS and comorbid PTSS/PTSD. A search of Medline, PsycInfo, Web of Science, Pubmed, and Scopus databases (2000 to 2023) was conducted following PRISMA guidelines. Nineteen articles were selected, including nine for meta-analysis. The main psychological therapies were pain-focused cognitive-behavioral therapy (P-CBT), and trauma-focused interventions, mainly written emotional disclosure (WED) and emotional awareness and expression therapy (EAET). Both EAET and P-CBT showed potential benefits in improving pain severity (specially EAET), PTSS/PTSD, emotional distress, fatigue, sleep disturbances, CSS-related symptoms, and quality of life. Overall, no significant differences were found between the two interventions. The meta-analysis revealed a large effect size for EAET in reducing pain and emotional distress; however, most comparison were against inactive controls, so results should be interpreted cautiously. These findings underscore the importance of distinguishing CSS patients with PTSS/PTSD. Tailored treatments such as EAET can address the additive impact of these conditions and contribute to improving patients’ quality of life.
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spelling doaj-art-301fc52fd46143869d3ef479edd0fe872025-08-24T11:31:02ZengNature PortfolioScientific Reports2045-23222025-08-0115111110.1038/s41598-025-16074-6Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: a systematic review and meta-analysisCoralie Maire0Ana I. Sánchez1José M. Ventura-Lucena2Elena Miró3M. Pilar Martínez4Department of Personality, Assessment and Psychological Treatment, Psychology Faculty, University of GranadaDepartment of Personality, Assessment and Psychological Treatment, Psychology Faculty, University of GranadaDepartment of Personality, Assessment and Psychological Treatment, Psychology Faculty, University of GranadaDepartment of Personality, Assessment and Psychological Treatment, Psychology Faculty, University of GranadaDepartment of Personality, Assessment and Psychological Treatment, Psychology Faculty, University of GranadaAbstract The co-occurrence of central sensitization syndromes (CSS) and post-traumatic symptoms (PTSS) or post-traumatic stress disorder (PTSD) exacerbates impairment, and treatment is unsatisfactory in many cases. This systematic review and meta-analysis examined the effectiveness of psychological therapy in individuals with CSS and comorbid PTSS/PTSD. A search of Medline, PsycInfo, Web of Science, Pubmed, and Scopus databases (2000 to 2023) was conducted following PRISMA guidelines. Nineteen articles were selected, including nine for meta-analysis. The main psychological therapies were pain-focused cognitive-behavioral therapy (P-CBT), and trauma-focused interventions, mainly written emotional disclosure (WED) and emotional awareness and expression therapy (EAET). Both EAET and P-CBT showed potential benefits in improving pain severity (specially EAET), PTSS/PTSD, emotional distress, fatigue, sleep disturbances, CSS-related symptoms, and quality of life. Overall, no significant differences were found between the two interventions. The meta-analysis revealed a large effect size for EAET in reducing pain and emotional distress; however, most comparison were against inactive controls, so results should be interpreted cautiously. These findings underscore the importance of distinguishing CSS patients with PTSS/PTSD. Tailored treatments such as EAET can address the additive impact of these conditions and contribute to improving patients’ quality of life.https://doi.org/10.1038/s41598-025-16074-6
spellingShingle Coralie Maire
Ana I. Sánchez
José M. Ventura-Lucena
Elena Miró
M. Pilar Martínez
Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: a systematic review and meta-analysis
Scientific Reports
title Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: a systematic review and meta-analysis
title_full Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: a systematic review and meta-analysis
title_fullStr Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: a systematic review and meta-analysis
title_full_unstemmed Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: a systematic review and meta-analysis
title_short Psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma: a systematic review and meta-analysis
title_sort psychological intervention in patients with central sensitization syndromes and comorbid psychosocial trauma a systematic review and meta analysis
url https://doi.org/10.1038/s41598-025-16074-6
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