Takeaway
- Psychological therapies reduced pain frequency immediately after treatment in children and adolescents with chronic headache and pain intensity and anxiety in those with other chronic pain conditions.
- The effects were not maintained at follow-up, except disability for children with mixed chronic pain conditions.
Why this matters
- 2014 review found that psychological therapies were effective in reducing pain frequency/intensity for children with headache and mixed chronic pain conditions immediately after treatment.
Study design
- Meta-analysis of 47 studies including 2884 children and adolescents with chronic and recurrent pain, identified after a search on CENTRAL, MEDLINE, MEDLINE in Process, EMBASE and PsycINFO databases until 2018.
- Funding: National Institutes of Health, USA; National Institute of Neurological Disorders and Stroke, USA.
Key results
- In children with headache pain:
- Psychological therapies showed a significant reduction in the pain frequency post-treatment (risk ratio [RR], 2.35; P<.01), but these effects were not maintained at follow-up (RR, 2.73; P=.06).
- Psychological therapies showed no beneficial effect on reducing disability in young people post-treatment (standardised mean difference [SMD], -0.26; P=.08), a beneficial effect in studies at follow-up (SMD, -0.37; P<.01).
- No beneficial effect of psychological interventions was seen in depression or anxiety symptoms.
- In children with mixed pain conditions:
- Psychological therapies showed a significant reduction in the pain intensity (SMD, -0.43; P<.01), but these effects were not maintained at follow-up (SMD, -0.08; P=.45).
- Psychological therapies significantly reduced disability post-treatment (SMD, -0.34; P<.01) and at follow-up (SMD, -0.27; P=.01).
- No benefit was seen in depression symptoms.
- Anxiety significantly decreased with psychological therapies post-treatment (SMD, -0.16; P=.02), but not at follow-up (SMD, 0.01; P=.92) `.
Limitations
- Low-quality evidence.
References
References