Richter 1986

Methods	RCT. 3 arms. Assessed at pre‐treatment, post‐treatment
Participants	End of treatment n = 43 Start of treatment n = 51 Sex: 34 F, 17 M Mean age = 12.9 Source = referred by physicians to children's hospital Diagnosis = migraine Mean years of pain = not given: most over 2 years
Interventions	"Relaxation training" "Cognitive coping" "Attention control"
Outcomes	Primary pain outcome: headache diary Primary disability outcome: none Primary depression outcome: Child Depression Rating Scale Primary anxiety outcome: State Trait Anxiety Inventory 1. Headache index (intensity, frequency, duration, medication taken: diary) 2. State Trait Anxiety Inventory (STAI) or State‐Trait Anxiety Inventory for Children (STAI‐C) 3. Children's Depression Rating Scale
Notes	Original study Total quality = 20/35 Treatment quality = 6/9 Design quality = 14/26
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	"... and randomly assigned to treatment" Comment: probably done, no method described
Allocation concealment (selection bias)	Unclear risk	No description found in text Comment: probably not done
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No description found in text Comment: probably not done
Incomplete outcome data (attrition bias) All outcomes	Low risk	"Over the course of treatment there were 8 drop‐outs. A chi‐square analysis comparing attrition rates across interventions was not significant." Comment: attrition adequately reported and no significant differences between completers and non‐completers reported
Selective reporting (reporting bias)	High risk	Data were incompletely reported