title: Maintaining lasting improvements: one-year follow-up of children with severe chronic pain undergoing multimodal inpatient treatment.
abstract: OBJECTIVE
  To investigate the long-term effectiveness of a 3-week multimodal inpatient program for children and adolescents with chronic pain.
  
  
  METHODS
  167 adolescents were evaluated at pretreatment baseline, 3-, and 12-month follow-up. Long-term effectiveness was investigated for pain-related variables (pain-related disability, school absence, pain intensity) and emotional distress.
  
  
  RESULTS
  We found statistically and clinically significant changes in all variables. After 1 year, the majority (56%) showed overall improvement as indexed by decreased pain-related disability or school absence. 22% had an unsuccessful treatment outcome. Those showing only short-term improvements had higher levels of emotional distress at baseline.
  
  
  CONCLUSIONS
  1 year after completing a multimodal inpatient program adolescents report less chronic pain, disability, and emotional distress. Clinically significant changes remain stable. Adolescents with high levels of emotional distress at admission may require special attention to maintain positive treatment outcomes. Specialized inpatient therapy is effective for children with chronic pain.
authors.affiliation: German Paediatric Pain Centre and Department of Children's Pain Therapy and Paediatric Palliative Care, Children's and Adolescents' Hospital, Datteln, Witten/Herdecke University, Faculty of Health, School of Medicine, Germany. T.Hechler@kinderklinik-datteln.de
authors.forename: Gerrit
authors.initials: G
authors.lastname: Hirschfeld
authors.forename: Tanja
authors.initials: T
authors.lastname: Hechler
authors.forename: Michael
authors.initials: M
authors.lastname: Dobe
authors.forename: Julia
authors.initials: J
authors.lastname: Wager
authors.forename: Pia
authors.initials: P
authors.lastname: von Lützau
authors.forename: Markus
authors.initials: M
authors.lastname: Blankenburg
authors.forename: Joachim
authors.initials: J
authors.lastname: Kosfelder
authors.forename: Boris
authors.initials: B
authors.lastname: Zernikow
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D059350:Chronic Pain / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007297:Inpatients; D008297:Male; D059408:Pain Management; D010147:Pain Measurement; D013315:Stress, Psychological / Q000523:psychology*; D016896:Treatment Outcome