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Cognitive behavior therapy for pediatric functional abdominal pain: a randomized controlled trial

Shelley M C van der Veek1, Bert H F Derkx, Marc A Benninga

  • 1Department of Child and Family Studies, Leiden University, PO Box 9555, 2300 RB Leiden, Netherlands. sveek@fsw.leidenuniv.nl.

Pediatrics
|October 16, 2013
PubMed

Insights

Cognitive behavior therapy (CBT) and intensive medical care (IMC) equally reduced functional abdominal pain in children. Both treatments improved secondary outcomes, suggesting comparable effectiveness for pediatric functional abdominal pain.

Area of Science:

  • Pediatric Gastroenterology
  • Child Psychology
  • Clinical Trials

Background:

  • Functional abdominal pain (FAP) is a common condition in children, significantly impacting their quality of life.
  • Current treatment approaches for pediatric FAP vary, with limited evidence comparing psychological interventions to standard medical care.

Purpose of the Study:

  • To compare the effectiveness of a 6-session protocolized cognitive behavior therapy (CBT) against 6 visits of intensive medical care (IMC) for treating pediatric functional abdominal pain (FAP).
  • To evaluate the impact of CBT versus IMC on abdominal pain levels, other gastrointestinal symptoms, functional disability, somatic complaints, anxiety, depression, and quality of life in children with FAP.

Main Methods:

  • A randomized controlled trial involving 104 children aged 7 to 18 with FAP.
  • Participants were randomized to receive either 6 sessions of CBT (delivered by master's students) or 6 visits of IMC (delivered by pediatricians/gastroenterologists).
  • Primary outcomes included self-reported abdominal pain via questionnaires and diaries, with assessments at pre-treatment, post-treatment, and 6- and 12-month follow-ups. Secondary outcomes encompassed a range of physical and psychological symptoms.

Main Results:

  • Both CBT and IMC led to significant reductions in abdominal pain (P < .001).
  • No significant differences in treatment effectiveness were observed between CBT and IMC at the 12-month follow-up for primary or secondary outcomes.
  • At 1 year, symptom improvement or recovery rates were similar: 60% for CBT vs. 56.4% for IMC (questionnaire data) and 65.8% for CBT vs. 62.8% for IMC (diary data).

Conclusions:

  • Cognitive behavior therapy (CBT) demonstrates equal effectiveness to intensive medical care (IMC) in alleviating functional abdominal pain in children.
  • The findings suggest that psychological interventions like CBT can be a viable alternative or adjunct to standard medical management for pediatric FAP.
  • Further research is warranted to elucidate the specific mechanisms through which CBT exerts its therapeutic effects in pediatric functional abdominal pain.
Abstract

Keywords:
cognitive behavior therapyfunctional abdominal painrandomized controlled trial

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