Table 2.
Psychological interventions
| Intervention | Participants | Results |
|---|---|---|
| Cognitive Behavioral Therapy | ||
| CBT vs no intervention [65] |
Children 6–18 years (N = 785) FAPDs (Rome II,III, IV criteria) and RAP (Apley criteria) |
Difference in treatment success in favor of CBT group (38% vs 15%) (RR 2.37, 95% CI 1.30 to 4.34; NNT = 5, 6 studies, 324 participants) CBT leads to lower pain frequency (RR − 0.36, 95% CI 0.63 to − 0.09; 7 studies, 446 participants) CBT leads to lower pain intensity (RR − 0.58, 95% CI 0.83 to − 0.32; 6 studies, 332 participants) |
| CBT vs educational support [65] |
Children 5–18 years (N = 975) FAPDs (Rome III, IV criteria) and RAP (Apley criteria) |
No difference in pain intensity between CBT group and educational support group (MD − 0.36, 95% CI 0.87 to − 0.15; 1 study, 127 participants) No difference in composite pain scores (MD − 0.07, 95% CI − 0.29 to 0.15; 1 study, 300 participants) |
| Hypnotherapy and guided imagery | ||
| HT vs no intervention [65] |
Children 6 to 18 years (N = 91) IBS/FAP (Rome II, III) |
Difference in treatment success in favor of HT group (56% vs 19%) (RR 2.86, 95% CI 1.19 to 6.83; NNT = 5, 2 studies, 91 participants) |
| Gut-directed HT vs HT [65] |
Children 6 to 17 years (N = 73) IBS/FAP (Rome III criteria) |
In both groups, results suggest a high efficacy of standardized home-based HT |
| Audio-recorded guided imagery vs no intervention [72] |
Children 6 to 15 years (N = 34) FAP (Rome II) |
ITT-analysis, significant difference in treatment responders (63% vs 27%; P = 0.03; NNT = 3); |
| Home-based HT vs iHT [71] |
Children 12 to 18 years (N = 260) IBS/FAP (Rome III criteria) |
Home-based HT by using a CD was non-inferior to individual HT group (62.1% vs 71%; P = 0.002) at 1-year follow-up |
| Yoga | ||
| Yoga vs no intervention [65] |
Children 8 to 18 years (N = 127) IBS/FAP (Rome I, III criteria) |
No difference in treatment success between both groups (28% vs 24%; P = 0.78) (RR 1.09, 95% CI 0.58 to 2.08, 2 studies, 99 participants) |
| Neurostimulation | ||
| Electrical neurostimulation (PENFS) [84]a |
Children 11 to 18 years (N = 115) AP-FGIDs (Rome III criteria) |
Significant difference in lower median PFSD composite scores with a mean decrease of 11.48 (95% CI 6.63 to 16.32; P < 0·0001); lower worst pain scores (p < 0·0001); improved global well-being (p = 0·0003) after 3 weeks; greater reduction in median PFSD composite scores (p = 0·018), and worst pain (p < 0·0001) compared with sham at long-term follow-up |
AP-FGID abdominal pain-related functional gastrointestinal disorder, CBT cognitive behavioral therapy, FAP functional abdominal pain, FAPD functional abdominal pain disorder, FGID functional gastrointestinal disorder, HT hypnotherapy, IBS irritable bowel syndrome, NNT number needed to treat, RAP recurrent abdominal pain, PENFS percutaneous electrical nerve field stimulation
aCompared with sham