Treatment of nonorganic recurrent abdominal pain: cognitive-behavioral family intervention.
OBJECTIVE
We evaluated the efficacy of cognitive-behavioral family intervention in the treatment of crises of pain in children with nonorganic recurrent abdominal pain (RAP) and the thresholds of pain for 17 body surface areas in these children.


METHODS
A randomized clinical trial was undertaken with 32 children between the ages of 5.1 and 13.9 years with nonorganic RAP. A group of 15 patients, aged 9.9 +/- 2.2 years (11 girls), received standard pediatric care and cognitive-behavioral family intervention for treatment of pain crises. The control group of 17 children, aged 8.4 +/- 2.0 years (11 girls), received only standard pediatric care. These procedures were undertaken by general pediatricians over 4 monthly sessions. An analog visual scale was used to measure the frequency and intensity of the pain crises per month and a mechanical pressure algometer for the measurement of pain threshold.


RESULTS
The median frequency of pain crises per month reported by patients at the 3 monthly cognitive-behavioral family intervention sessions was 15, 5, 2 and 2, respectively. In contrast, the median frequency for pain crises per month reported by the control group was 12, 8, 10 and 8, respectively. The difference between the intervention group and the controls was statistically significant for frequency of pain at the second, third and fourth visits. There was no statistical difference for intensity of pain or for measured pain thresholds between the control and the intervention group.


CONCLUSIONS
The cognitive-behavioral family intervention reduced the frequency of pain crises of children with nonorganic RAP. This successful intervention was carried out by the intervention of general pediatricians.
Duarte
Marco Antônio
MA
Department of Pediatrics, Faculty of Medicine, Federal University of Minas Gerais, Brazil. duartemm@terra.com.br
Penna
Francisco José
FJ
Andrade
Eugênio Marcos Goulart
EM
Cancela
Camila Silva Peres
CS
Neto
Joaquim Caetano Aguirre
JC
Barbosa
Terezinha Facury
TF
D015746:Abdominal Pain / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D000293:Adolescent; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy; D005196:Family Therapy; D005260:Female; D006801:Humans; D008297:Male; D009819:Office Visits; D010147:Pain Measurement; D017288:Pain Threshold; D010287:Parent-Child Relations; D012008:Recurrence; D016896:Treatment Outcome