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.
Youssef
Nader N
NN
Division of Pediatric Gastroenterology, University of Medicine & Dentistry, New Jersey Goryeb Children's Hospital, Morristown 07962, USA. nader.youssef@ahsys.org
Rosh
Joel R
JR
Loughran
Mary
M
Schuckalo
Stephanie G
SG
Cotter
Ann N
AN
Verga
Barbara G
BG
Mones
Richard L
RL
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