Treatment of functional abdominal pain in childhood with cognitive behavioral strategies.
OBJECTIVE
The aim of this study was to assess the efficacy of a cognitive-behavioral approach to the treatment of recurrent abdominal pain caused by childhood functional gastrointestinal disorders (FGIDs).


METHODS
From September 2001 to December 2002, 18 patients (12 male; mean age, 12.1 +/- 4.9 years) with chronic abdominal pain (mean duration, 11.8 +/- 13.3 months) caused by FGIDs were referred to our facility's mind-body institute (MBI). Treatment included guided imagery and progressive relaxation techniques. The mean number of sessions per patient was 4.3 +/- 3.4. Outcomes included change in abdominal pain and quality of life, evaluated by the Pediatric Quality of Life Scale (PedsQL). Follow-up was 10.6 +/- 2.3 months after the last MBI session.


RESULTS
Abdominal pain improved in 89% of patients; weekly pain episodes decreased from 5.5 +/- 0.9 to 2.0 +/- 2.7 (P < 0.05); pain intensity (0 to 3 scale) decreased from 2.7 +/- 0.6 to 0.6 +/- 0.7 (P < 0.04); missed school days/month decreased from 4.6 +/- 1.7 to 1.4 +/- 3.2 (P < 0.05); social activities/week increased from 0.3 +/- 0.6 to 1.3 +/- 0.6 (P < 0.05); physician office contacts/year decreased from 24 +/- 10.2 to 8.7 +/- 13.1 (P = 0.07). PedsQL scores (0 to 100 scale) improved from 55.3 +/- 11.9 to 80.0 +/- 10.7 (P < 0.03).


CONCLUSIONS
Guided imagery and progressive relaxation can safely and effectively reduce chronic abdominal pain in children with FGIDs. This treatment also improved social functioning and school attendance.
Division of Pediatric Gastroenterology, University of Medicine & Dentistry, New Jersey Goryeb Children's Hospital, Morristown 07962, USA. nader.youssef@ahsys.org
Nader N
NN
Youssef
Joel R
JR
Rosh
Mary
M
Loughran
Stephanie G
SG
Schuckalo
Ann N
AN
Cotter
Barbara G
BG
Verga
Richard L
RL
Mones
D015746:Abdominal Pain / Q000523:psychology* / Q000628:therapy*; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D019018:Imagery, Psychotherapy / Q000379:methods*; D008297:Male; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012008:Recurrence; D012063:Relaxation; D012189:Retrospective Studies; D016896:Treatment Outcome