title: Cognitive behavior therapy for pediatric functional abdominal pain: a randomized controlled trial.
abstract: OBJECTIVE
  This randomized controlled trial investigated the effectiveness of a 6-session protocolized cognitive behavior therapy (CBT) compared with 6 visits to a pediatrician (intensive medical care; IMC) for the treatment of pediatric functional abdominal pain (FAP).
  
  
  METHODS
  One hundred four children aged 7 to 18 were randomized to CBT or IMC. CBT was delivered primarily by trained master's degree students in psychology; IMC was delivered by pediatricians or pediatric gastroenterologists. Assessments were performed pretreatment, posttreatment, and at 6- and 12-month follow-up. Primary outcomes were level of abdominal pain (AP) as reported on questionnaires and diaries. Secondary outcomes were other gastrointestinal complaints, functional disability, other somatic complaints, anxiety, depression, and quality of life.
  
  
  RESULTS
  Both CBT and IMC resulted in a significant decrease in AP (P < .001), but no significant difference was found between the treatments in their effectiveness (P > .05 for all end points). According to the questionnaire-derived data, 1 year after treatment, 60% of children that received CBT had significantly improved or recovered, versus 56.4% of children receiving IMC, which did not significantly differ (P = .47). These percentages were 65.8% versus 62.8% according to the diary-derived data, which also did not significantly differ (P = .14). Additionally, nearly all secondary outcomes improved after treatment.
  
  
  CONCLUSIONS
  CBT was equally effective as IMC in reducing AP in children with FAP. More research into the specific working mechanisms of CBT for pediatric FAP is needed.
authors.affiliation: Department of Child and Family Studies, Leiden University, PO Box 9555, 2300 RB Leiden, Netherlands. sveek@fsw.leidenuniv.nl.
authors.forename: Shelley M C
authors.initials: SM
authors.lastname: van der Veek
authors.forename: Bert H F
authors.initials: BH
authors.lastname: Derkx
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
authors.forename: Frits
authors.initials: F
authors.lastname: Boer
authors.forename: Else
authors.initials: E
authors.lastname: de Haan
mesh_terms: D015746:Abdominal Pain / Q000523:psychology* / Q000628:therapy*; D000293:Adolescent; D002648:Child; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: cognitive behavior therapy; functional abdominal pain; randomized controlled trial