title: Gut-directed hypnotherapy in children with irritable bowel syndrome or functional abdominal pain (syndrome): a randomized controlled trial on self exercises at home using CD versus individual therapy by qualified therapists.
abstract: BACKGROUND
  Irritable bowel syndrome (IBS) and functional abdominal pain (syndrome) (FAP(S)) are common pediatric disorders, characterized by chronic or recurrent abdominal pain. Treatment is challenging, especially in children with persisting symptoms. Gut-directed hypnotherapy (HT) performed by a therapist has been shown to be effective in these children, but is still unavailable to many children due to costs, a lack of qualified child-hypnotherapists and because it requires a significant investment of time by child and parent(s). Home-based hypnotherapy by means of exercises on CD has been shown effective as well, and has potential benefits, such as lower costs and less time investment. The aim of this randomized controlled trial (RCT) is to compare cost-effectiveness of individual HT performed by a qualified therapist with HT by means of CD recorded self-exercises at home in children with IBS or FAP(S).
  
  
  METHODS
  260 children, aged 8-18 years with IBS or FAP(S) according to Rome III criteria are included in this currently conducted RCT with a follow-up period of one year. Children are randomized to either 6 sessions of individual HT given by a qualified therapist over a 3-month period or HT through self-exercises at home with CD for 3 months.The primary outcome is the proportion of patients in which treatment is successful at the end of treatment and after one year follow-up. Treatment success is defined as at least 50% reduction in both abdominal pain frequency and intensity scores. Secondary outcomes include adequate relief, cost-effectiveness and effects of both therapies on depression and anxiety scores, somatization scores, QoL, pain beliefs and coping strategies.
  
  
  CONCLUSIONS
  If the effectiveness of home-based HT with CD is comparable to, or only slightly lower, than HT by a therapist, this treatment may become an attractive form of therapy in children with IBS or FAP(S), because of its low costs and direct availability.
  
  
  BACKGROUND
  Dutch Trial Register number NTR2725 (date of registration: 1 February 2011).
authors.affiliation: Department of Pediatric Gastroenterology, Emma Children's Hospital/Academic Medical Center, PO Box 22700, 1100 DD Amsterdam, The Netherlands. j.m.rutten@amc.nl.
authors.forename: Juliette M T M
authors.initials: JM
authors.lastname: Rutten
authors.forename: Arine M
authors.initials: AM
authors.lastname: Vlieger
authors.forename: Carla
authors.initials: C
authors.lastname: Frankenhuis
authors.forename: Elvira K
authors.initials: EK
authors.lastname: George
authors.forename: Michael
authors.initials: M
authors.lastname: Groeneweg
authors.forename: Obbe F
authors.initials: OF
authors.lastname: Norbruis
authors.forename: Walther
authors.initials: W
authors.lastname: Tjon a Ten
authors.forename: Herbert
authors.initials: H
authors.lastname: Van Wering
authors.forename: Marcel G W
authors.initials: MG
authors.lastname: Dijkgraaf
authors.forename: Maruschka P
authors.initials: MP
authors.lastname: Merkus
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
mesh_terms: D015746:Abdominal Pain / Q000523:psychology / Q000628:therapy*; D000223:Adaptation, Psychological; D000293:Adolescent; D001007:Anxiety / Q000517:prevention & control; D002648:Child; D003362:Cost-Benefit Analysis; D006801:Humans; D006990:Hypnosis / Q000379:methods*; D043183:Irritable Bowel Syndrome / Q000523:psychology / Q000628:therapy*; D009426:Netherlands; D012648:Self Care; D013315:Stress, Psychological / Q000517:prevention & control; D011795:Surveys and Questionnaires