Cognitive Behavioral Therapy Can Help Stomach Pain in Kids

Lara C. Pullen, PhD

October 14, 2013

In children with functional abdominal pain, cognitive behavioral therapy (CBT) is as effective in reducing abdominal pain as intensive medical care (IMC) delivered by pediatricians or pediatric gastroenterologists (P > 0.05 for all endpoints).

Shelley M.C. van der Veek, PhD, from the Academic Medical Center in Amsterdam, the Netherlands, and colleagues describe the results of their randomized controlled trial comparing CBT with IMC in an article published online October 14 in Pediatrics.

The investigators enrolled 104 children aged 7 to 18 years in the study. Patients assigned to CBT received 6 sessions of protocolized CBT delivered by a trained Master's student in psychology. The CBT protocol was modular, and not every child received the exact same treatment.

Patients assigned to IMC had 6 visits to a pediatrician or pediatric gastroenterologist. The IMC control was specifically designed to ensure that children in both the CBT and IMC treatment groups received equal amounts of attention from their therapist or physician. There was, however, a distinct difference in clinical experience between the therapists delivering CBT and the physicians delivering IMC.

The researchers assessed the children at 4 points: pretreatment, posttreatment, and at 6- and 12-month follow-up. They found that both CBT and IMC resulted in a significant decrease in abdominal pain (P < .001).

According to questionnaires, 60% of children with functional abdominal pain who receive CBT had reduced abdominal pain at 1 year after treatment. This is similar to the 56.4% of children who had reduced abdominal pain in the IMT group (P = .47).

Analysis of diary-derived data revealed a 65.8% recovery rate for CBT and a 62.8% recovery rate for IMC (P = .14). Most secondary outcomes (functional disability, somatic complaints, anxiety, depression, and quality of life) also improved after treatment.

Functional abdominal pain is a common complain among children. The authors note that the IMC described in this study may not be feasible outside of an experimental setting because of the limited availability of pediatricians.

The authors have disclosed no relevant financial relationships.

Pediatrics. Published online October 14, 2013.

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