There are at least 40 controlled studies of variable methodologic quality on the use of hypnosis for treating acute pain in adult and pediatric populations. All but three studies show superiority of hypnosis over a control condition (usual care, no treatment, or attentional control). Hypnosis has been shown to be effective for periprocedural and perioperative pain in patients undergoing breast lumpectomy, excisional and core breast biopsy, bone marrow aspiration, pectus excavatum repair (Nuss procedure), percutaneous transluminal coronary angioplasty and other percutaneous vascular and renal procedures, burn wound care, dental procedures, and plastic surgery. Many studies also report less procedure-related anxiety and lower analgesic medication requirement. According to a 2013 meta-analysis, additional documented benefits include reduced recovery and surgical procedure times. A 2014 meta-analysis concludes that hypnosis is superior to some other psychological interventions for the treatment of chronic pain. A small 2013 three-arm randomized controlled trial suggests live hypnosis is superior to both recorded hypnosis and placebo for reducing anxiety during dermatologic procedures. A 2016 randomized controlled trial of 53 older hospitalized patients (mean age 80 years) found that hypnosis caused a greater reduction in pain than massage, and it also significantly improved mood.
For chronic pain, individual studies have shown efficacy for headache, orofacial pain, dyspepsia, low back pain, vulvodynia, sickle cell crisis, fibromyalgia, multiple sclerosis, and spinal cord injury.
B. Cancer-Related Symptoms
There are at least 15 randomized controlled trials that have specifically evaluated the efficacy of hypnosis for cancer-related pain, distress, fatigue, nausea, and hot flashes in adults, usually involving adults with breast cancer. All trials showed benefit compared with no treatment or usual care. In addition, three of four trials showed significant benefit of hypnosis for reducing anticipatory nausea and vomiting from chemotherapy. Other randomized controlled trials concluded that (1) hypnosis decreased hot flash scores by 68% in breast cancer survivors; (2) self-hypnosis plus empathic attention was superior to empathic attention alone for reducing pain, anxiety, and medication usage in 201 patients undergoing percutaneous tumor treatment; (3) hypnosis preoperatively reduced institutional costs for breast cancer patients; (4) hypnosis reduced the doses of anesthesia medications required and reduced pain, fatigue, nausea, and emotional upset in breast cancer patients; and (5) a combined intervention of hypnosis with CBT reduced fatigue in one study of breast cancer patients undergoing radiation therapy and, in another study, reduced negative affect and increased positive affect in a similar patient population.
C. Irritable Bowel Syndrome
There are more than 20 studies of hypnosis for irritable bowel syndrome in adults, seven of which are controlled (placebo pill, CBT, or wait-list control). All seven controlled studies show reduction in pain and bowel symptoms, and some show improved quality of life and reduced anxiety. There are also five follow-up studies showing maintenance of benefits for 1–7 years. Two large studies (one prospective randomized controlled trial and one retrospective trial) examined refractory irritable bowel syndrome patients and found efficacy for hypnosis. The American College of Gastroenterology includes hypnosis among its recommended behavioral therapies for the treatment of irritable bowel syndrome. Among the pediatric population, a 2017 prospective randomized controlled study of 250 children with irritable bowel syndrome and functional abdominal pain found that home-based hypnotherapy with an audio file was noninferior to individual hypnotherapy performed by therapists. This study adds another treatment option for these patients.
A 2012 Cochrane review of 11 trials concluded that whether hypnosis is superior to other interventions or to no treatment for smoking cessation cannot be determined because of conflicting results and statistical weaknesses in head-to-head trials. Similarly, a 2012 meta-analysis found hypnosis may possibly aid smoking cessation, but a large confidence interval in the final statistical analysis prevented the authors from stating any definitive conclusion. A 2016 randomized controlled three-arm trial in 164 hospitalized patients concluded that hypnotherapy was superior to nicotine replacement therapy as measured by abstinence rates at 12 and 26 weeks post-hospitalization (however, the statistical significance of this conclusion was questionable). A 2017 randomized controlled study of 140 veterans did not find any significant improvements when hypnosis was used for smoking relapse prevention.
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