Psychological therapies for the management of chronic and recurrent pain in children and adolescents.

Christopher Eccleston, Tonya M. Palermo, Amanda C. de C Williams, Amy Holley, Stephen Morley, Emma Fisher, Emily Law

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Chronic pain affects many children, who report severe pain, distressed mood, and disability. Psychological therapies are emerging as effective interventions to treat children with chronic or recurrent pain. This update adds recently published randomised controlled trials (RCTs) to the review published in 2009. To assess the effectiveness of psychological therapies, principally cognitive behavioural therapy and behavioural therapy, for reducing pain, disability, and improving mood in children and adolescents with recurrent, episodic, or persistent pain. We also assessed the risk of bias and methodological quality of the included studies. Searches were undertaken of MEDLINE, EMBASE, and PsycLIT. We searched for RCTs in references of all identified studies, meta-analyses and reviews. Date of most recent search: March 2012. RCTs with at least 10 participants in each arm post-treatment comparing psychological therapies with active treatment were eligible for inclusion (waiting list or standard medical care) for children or adolescents with episodic, recurrent or persistent pain. All included studies were analysed and the quality of the studies recorded. All treatments were combined into one class: psychological treatments; headache and non-headache outcomes were separately analysed on three outcomes: pain, disability, and mood. Data were extracted at two time points; post-treatment (immediately or the earliest data available following end of treatment) and at follow-up (at least three months after the post-treatment assessment point, but not more than 12 months). Eight studies were added in this update of the review, giving a total of 37 studies. The total number of participants completing treatments was 1938. Twenty-one studies addressed treatments for headache (including migraine); seven for abdominal pain; four included mixed pain conditions including headache pain, two for fibromyalgia, two for pain associated with sickle cell disease, and one for juvenile idiopathic arthritis. Analyses revealed five significant effects. Pain was found to improve for headache and non-headache groups at post-treatment, and for the headache group at follow-up. Mood significantly improved for the headache group at follow-up, although, this should be interpreted with caution as there were only two small studies entered into the analysis. Finally, disability significantly improved in the non-headache group at post-treatment. There were no other significant effects. Psychological treatments are effective in reducing pain intensity for children and adolescents (

Original languageEnglish (US)
JournalCochrane database of systematic reviews (Online)
Volume12
StatePublished - 2012
Externally publishedYes

Fingerprint

Chronic Pain
Psychology
Pain
Headache
Therapeutics
Randomized Controlled Trials
Waiting Lists
Juvenile Arthritis
Fibromyalgia
Sickle Cell Anemia
Cognitive Therapy
Child Care
Migraine Disorders
MEDLINE
Abdominal Pain
Meta-Analysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Psychological therapies for the management of chronic and recurrent pain in children and adolescents. / Eccleston, Christopher; Palermo, Tonya M.; de C Williams, Amanda C.; Holley, Amy; Morley, Stephen; Fisher, Emma; Law, Emily.

In: Cochrane database of systematic reviews (Online), Vol. 12, 2012.

Research output: Contribution to journalArticle

Eccleston, Christopher ; Palermo, Tonya M. ; de C Williams, Amanda C. ; Holley, Amy ; Morley, Stephen ; Fisher, Emma ; Law, Emily. / Psychological therapies for the management of chronic and recurrent pain in children and adolescents. In: Cochrane database of systematic reviews (Online). 2012 ; Vol. 12.
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