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Meta-Analysis
. 2014 Sep;39(8):763-82.
doi: 10.1093/jpepsy/jsu008. Epub 2014 Mar 6.

Systematic review and meta-analysis of psychological therapies for children with chronic pain

Emma Fisher  1 , Lauren Heathcote  2 , Tonya M Palermo  2 , Amanda C de C Williams  2 , Jennifer Lau  2 , Christopher Eccleston  2
Affiliations
Meta-Analysis

Systematic review and meta-analysis of psychological therapies for children with chronic pain

Emma Fisher et al. J Pediatr Psychol. 2014 Sep.

Abstract

Objectives: This systematic review and meta-analysis examined the effects of psychological therapies for management of chronic pain in children.

Methods: Randomized controlled trials of psychological interventions treating children (<18 years) with chronic pain conditions including headache, abdominal, musculoskeletal, or neuropathic pain were searched for. Pain symptoms, disability, depression, anxiety, and sleep outcomes were extracted. Risk of bias was assessed and quality of the evidence was rated using GRADE.

Results: 35 included studies revealed that across all chronic pain conditions, psychological interventions reduced pain symptoms and disability posttreatment. Individual pain conditions were analyzed separately. Sleep outcomes were not reported in any trials. Optimal dose of treatment was explored. For headache pain, higher treatment dose led to greater reductions in pain. No effect of dosage was found for other chronic pain conditions.

Conclusions: Evidence for psychological therapies treating chronic pain is promising. Recommendations for clinical practice and research are presented.

Keywords: adolescents; children; chronic pain; psychological interventions.

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Figures

Figure 1.
Figure 1.
PRISMA 2009 flow diagram.
Figure 2.
Figure 2.
Risk of bias.
Figure 3.
Figure 3.
Treatment versus control, chronic pain (excluding headache) conditions, pain posttreatment.
Figure 4.
Figure 4.
Treatment versus control, headache pain posttreatment.
Figure 5.
Figure 5.
Labbe plot of treatment versus control, headache pain posttreatment.
See this image and copyright information in PMC

References

    1. *Note: Studies marked with an asterisk (*) met the inclusion criteria for this review.
    1. *Abram H S, Buckloh L M, Schilling L S, Armatti Wiltrout S, Ramirez-Garnica G, Turk W R. A randomized, controlled trail of a neurological and psychoeducational group appointment model for pediatric headaches. Children’s Healthcare. 2007;36:249–265.
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    1. *Barry J, von Baeyer C L. Brief cognitive-behavioral group treatment for children’s headache. Clinical Journal of Pain. 1997;13:215–220. - PubMed

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