TY - JOUR
T1 - Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents
T2 - An updated meta-analytic review
AU - Palermo, Tonya M.
AU - Eccleston, Christopher
AU - Lewandowski, Amy S.
AU - Williams, Amanda C.de C.
AU - Morley, Stephen
N1 - Funding Information:
This work was partially supported by an International Association for the Study of Pain Collaborative Research Grant awarded to T.P. and C.E. and by NIH K24HD060068 (T.P.). We would like to thank Hannah Somhegyi and Simona Patange for their assistance with data extraction and coding. In addition, we thank the following authors, Drs. Carrie Hicks, Paul Robins, Lisa Scharff, and Carl von Baeyer who provided additional data from their studies for the meta-analysis.
PY - 2010/3
Y1 - 2010/3
N2 - The purpose of this meta-analytic review was to quantify the effects of psychological therapies for the management of chronic pain in youth. Specifically, in this review we updated previous systematic reviews of randomized controlled trials by including new trials, and by adding disability and emotional functioning to pain as treatment outcomes. Electronic searches of the Cochrane Register of Randomised Controlled Trials, MEDLINE, PsycLIT, EMBASE, and the Social Sciences Citation Index were conducted from inception through August 2008. Methodological quality of the studies was assessed, and data extracted on the three primary outcomes of interest. Twenty-five trials including 1247 young people met inclusion criteria and were included in the meta-analysis. Meta-analytic findings demonstrated a large positive effect of psychological intervention on pain reduction at immediate post-treatment and follow-up in youth with headache, abdominal pain, and fibromyalgia. Small and non-significant effects were found for improvements in disability and emotional functioning, although there were limited data on these outcomes available in the included studies. Omnibus cognitive-behavioral therapy, relaxation therapy, and biofeedback all produced significant and positive effects on pain reduction. Studies directly comparing the effects of self-administered versus therapist-administered interventions found similar effects on pain reduction. Psychological therapies result in improvement in pain relief across several different pain conditions in children. Future trials are needed that incorporate non-pain outcome domains, that focus significant therapeutic content on reductions in disability, and that include extended follow-up to better understand maintenance of treatment effects.
AB - The purpose of this meta-analytic review was to quantify the effects of psychological therapies for the management of chronic pain in youth. Specifically, in this review we updated previous systematic reviews of randomized controlled trials by including new trials, and by adding disability and emotional functioning to pain as treatment outcomes. Electronic searches of the Cochrane Register of Randomised Controlled Trials, MEDLINE, PsycLIT, EMBASE, and the Social Sciences Citation Index were conducted from inception through August 2008. Methodological quality of the studies was assessed, and data extracted on the three primary outcomes of interest. Twenty-five trials including 1247 young people met inclusion criteria and were included in the meta-analysis. Meta-analytic findings demonstrated a large positive effect of psychological intervention on pain reduction at immediate post-treatment and follow-up in youth with headache, abdominal pain, and fibromyalgia. Small and non-significant effects were found for improvements in disability and emotional functioning, although there were limited data on these outcomes available in the included studies. Omnibus cognitive-behavioral therapy, relaxation therapy, and biofeedback all produced significant and positive effects on pain reduction. Studies directly comparing the effects of self-administered versus therapist-administered interventions found similar effects on pain reduction. Psychological therapies result in improvement in pain relief across several different pain conditions in children. Future trials are needed that incorporate non-pain outcome domains, that focus significant therapeutic content on reductions in disability, and that include extended follow-up to better understand maintenance of treatment effects.
KW - Children
KW - Chronic pain
KW - Meta-analysis
KW - Pain
KW - Psychological therapies
KW - Randomized controlled trials
KW - Systematic review
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U2 - 10.1016/j.pain.2009.10.004
DO - 10.1016/j.pain.2009.10.004
M3 - Article
C2 - 19910118
AN - SCOPUS:76349123160
SN - 0304-3959
VL - 148
SP - 387
EP - 397
JO - Pain
JF - Pain
IS - 3
ER -