Systematic Review and Meta-Analysis of Psychological Therapies for Children With Chronic Pain

Fisher, Emma; Heathcote, Lauren C.; Palermo, Tonya M.; Williams, Amanda C de C; Lau, Jennifer Y. F.; Eccleston, Christopher

doi:10.1093/jpepsy/jsu008

Cited by 272 publications

(186 citation statements)

References 78 publications

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“…Another review of psychological treatment of headaches concluded that higher treatment dose leads to better pain scores posttreatment. 38 The studies included in this review delivered biofeedback in a clinic, which is time-consuming for the patient and hampers the widespread delivery of treatment, despite its positive results in treating headache. This finding has led to the emergence of less time-consuming approaches, such as prudent limited office treatment and Internet-based delivery.…”

Section: Discussionmentioning

confidence: 99%

Biofeedback as Prophylaxis for Pediatric Migraine: A Meta-analysis

et al. 2016

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CONTEXT: Migraine is a common problem in children and adolescents, but few satisfactory prophylactic treatments exist. OBJECTIVE:Our goal was to investigate the pooled evidence for the effectiveness of using biofeedback to reduce childhood migraine.DATA SOURCES: A systematic search was conducted across the databases Medline, Embase, CENTRAL, CINAHL, and PsychINFO.STUDY SELECTION: Prospective, randomized controlled trials of biofeedback for migraine among children and adolescents were located in the search.DATA EXTRACTION: Data on reduction of mean attack frequency and a series of secondary outcomes, including adverse events, were extracted. Risk of bias was also assessed.RESULTS: Forest plots were created by using a fixed effects model, and mean differences were reported. Five studies with a total of 137 participants met the inclusion criteria. Biofeedback reduced migraine frequency (mean difference, -1.97 [95% confidence interval (CI), -2.72 to -1.21]; P < .00001), attack duration (mean difference, -3.94 [95% CI, -5.57 to -2.31]; P < .00001), and headache intensity (mean difference, -1.77 [95% CI, -2.42 to -1.11]; P < .00001) compared with a waiting-list control. Biofeedback demonstrated no adjuvant effect when combined with other behavioral treatment; neither did it have significant advantages over active treatment. Only 40% of bias judgments were deemed as "low" risk. LIMITATIONS:Methodologic issues hampered the meta-analyses. Only a few studies were possible to include, and they suffered from incomplete reporting of data and risk of bias.CONCLUSIONS: Biofeedback seems to be an effective intervention for pediatric migraine, but in light of the limitations, further investigation is needed to increase our confidence in the estimate.

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Section: Discussionmentioning

confidence: 99%

Biofeedback as Prophylaxis for Pediatric Migraine: A Meta-analysis

et al. 2016

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“…Previous reviews highlight the effectiveness of psychological therapies for the treatment of chronic pain in youth, 14,15 but no reviews have examined the benefits of IIPT, despite the growing need for and interest in this particular form of treatment. In addition, although we know the components of IIPT programs for youth with chronic pain are diverse, no previous studies have systematically examined the programs and described the treatments.…”

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confidence: 99%

Systematic Review on Intensive Interdisciplinary Pain Treatment of Children With Chronic Pain

et al. 2015

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“…The changes that occur in chronic pain to the entire central nervous system and brain do not differentiate in any way between, for instance, the individual with diagnosed osteoarthritis or the individual with joint pain but no X-ray findings, nor between the individual with celiac disease and another with irritable bowel syndrome. 48 Although much research and clinical effort have focused on adults of working age with chronic pain, CBT has been applied to help children 18,49 and older adults, 50 and to those with pain at the end of life. [51][52][53][54] We suspect that clinicians and researchers will continue to apply the general principles of CBT to a wide range of pain-related disorders.…”

Section: Likely Developments and Challengesmentioning

confidence: 99%

New Developments in the Psychological Management of Chronic Pain

Morley

Williams

2015

Can J Psychiatry

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After reviewing how psychological treatment for chronic pain comes to have its current form, and summarizing treatment effectiveness, we explore several areas of development. We describe third wave therapies, such as mindfulness; we discuss what the research literature aggregated can tell us about what trials are more useful to conduct; and we outline some areas of promise and some failures to deliver on promise. The article is drawn together using the framework of the normal psychology of pain, identifying some of its most important implications for improving life for people with chronic pain. W W W Nouveaux développements de la prise en charge psychologique de la douleur chroniqueAprès avoir étudié comment le traitement psychologique de la douleur chronique en est venu à sa forme actuelle, et résumé l'efficacité des traitements, nous explorons plusieurs domaines du développement. Nous décrivons les thérapies de troisième vague comme la pleine conscience, nous discutons de ce que peut nous apprendre la littérature de recherche regroupée à propos des essais les plus utiles à mener, nous présentons des domaines prometteurs et d'autres qui n'ont pas tenu leur promesse. La structure de l'article est le cadre de la psychologie normale de la douleur, qui identifie certaines des implications les plus importantes pour améliorer la vie des personnes souffrant de douleur chronique. P sychological treatments for chronic pain have been in continuous development since the 1960s, broadly parallel to changes in mainstream psychological treatments, especially within the ambit of CBT. There are several conceptual threads that can be discerned in the current state. 1 BehaviouralBehavioural methods apply operant learning theory to the analysis of pain. The primary objective is to modify a range of pain-related behaviours, such as activity, medication use, and social interactions, by changing environmental contingencies and the settings in which pain-related behaviour occurs. The cardinal feature of the original behavioural approach was that it explicitly eschewed direct attempts to modify the sensory-intensity component of the pain experience. 2

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Systematic Review and Meta-Analysis of Psychological Therapies for Children With Chronic Pain

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

Cited by 272 publications

References 78 publications

Biofeedback as Prophylaxis for Pediatric Migraine: A Meta-analysis

Biofeedback as Prophylaxis for Pediatric Migraine: A Meta-analysis

Systematic Review on Intensive Interdisciplinary Pain Treatment of Children With Chronic Pain

New Developments in the Psychological Management of Chronic Pain

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