Cochrane · systematic review · CD003968
Psychological therapies for the management of chronic and recurrent pain in children and adolescents
Fisher, E, Law, E, Dudeney, J, et al. · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
14
No studies
1
Included studies
NR
No studies 1 · 6.7%Ungraded 0 · 0%Very low 10 · 66.7%Low 4 · 26.7%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlySummary of findings
Population: Children and adolescents with chronic pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain: 50% reduction in headache frequency Post‐treatment Lower scores = fewer headaches | RR 2.35 [1.67, 3.3] | 15 studies · 644 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Pain: 50% reduction in headache frequency | RR 2.73 [0.98, 7.63] | 5 studies · 223 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Disability Post‐treatment Lower scores = lower reported disability | no estimate extracted | 6 studies · 446 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Disability | no estimate extracted | 3 studies · 209 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, publication bias |
Anxiety Post‐treatment Lower scores = lower reported anxiety | no estimate extracted | 7 studies · 439 participants | Very low Downgraded: risk of bias |
Anxiety | no estimate extracted | 4 studies · 271 participants | Very low Downgraded: risk of bias |
Depression Post‐treatment Lower scores = lower reported depression | no estimate extracted | 6 studies · 400 participants | Very low Downgraded: risk of bias |
Summary of findings
Population: Children and adolescents with chronic pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain Post‐treatment Lower scores = lower reported pain intensity | no estimate extracted | 16 studies · 1210 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Pain | no estimate extracted | 9 studies · 763 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
Disability Post‐treatment Lower scores = lower reported disability | no estimate extracted | 14 studies · 1226 participants | Low Downgraded: risk of bias, inconsistency, publication bias |
Disability | no estimate extracted | 9 studies · 866 participants | Low Downgraded: risk of bias, inconsistency, publication bias |
Anxiety Post‐treatment Lower scores = lower reported anxiety | no estimate extracted | 8 studies · 883 participants | Low Downgraded: risk of bias, inconsistency, publication bias |
Anxiety | no estimate extracted | 8 studies · 805 participants | Low Downgraded: risk of bias, inconsistency, publication bias |
Depression Post‐treatment Lower scores = lower reported depression | no estimate extracted | 8 studies · 757 participants | Very low Downgraded: risk of bias, inconsistency, publication bias |
CI: Confidence interval. | no estimate extracted | NR | No studies |
Comparison
Population: children and adolescents with frequent headache
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (low scores mean lower pain ratings) | RR 2.47 [1.97, 3.09] | 15 studies · 714 participants | Low |
Pain (at | RR 2.89 [1.03, 8.07] | 5 studies · 251 participants | Very low |
Disability (low scores mean lower disability ratings) | no estimate extracted | 3 studies · 263 participants | Low |
Disability (at | no estimate extracted | 2 studies · 148 participants | Low |
Depression (low scores mean lower depression ratings) | no estimate extracted | 3 studies · 164 participants | Moderate |
Anxiety (low scores mean lower anxiety ratings) | no estimate extracted | 4 studies · 203 participants | Low |
Anxiety (at | no estimate extracted | 2 studies · 67 participants | Very low |
Comparison
Population: children and adolescents with non‐headache pain
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain (low scores mean lower pain ratings) | no estimate extracted | 13 studies · 852 participants | Very low |
Pain (at | no estimate extracted | 7 studies · 543 participants | Low |
Disability (low scores mean lower disability ratings) | no estimate extracted | 11 studies · 764 participants | Very low |
Disability (at | no estimate extracted | 6 studies · 508 participants | Low |
Depression (low scores mean lower depression ratings) | no estimate extracted | 6 studies · 538 participants | Moderate |
Depression (at | no estimate extracted | 5 studies · 473 participants | Moderate |
Anxiety (low scores mean lower anxiety ratings) | no estimate extracted | 5 studies · 498 participants | Moderate |
Psychological therapies for the management of chronic pain (headache) in children and adolescents
Population: patients with the management of chronic and recurrent pain in children and adolescents
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain | RR 2.9 [2.25, 3.73] | 18 studies · 748 participants | Moderate |
Pain (at | RR 3.34 [2.01, 5.53] | 6 studies · 196 participants | Low Downgraded: imprecision |
Disability | no estimate extracted | 3 studies · 108 participants | Moderate Downgraded: inconsistency |
Disability (at | no estimate extracted | 1 study · 24 participants | Low Downgraded: imprecision |
Mood | no estimate extracted | 5 studies · 204 participants | High |
Mood (at | no estimate extracted | 2 studies · 59 participants | Moderate Downgraded: imprecision |
Psychological therapies for the management of chronic (non‐headache) in children and adolescents
Population: Children and adolescents with chronic pain (non‐headache)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Pain | no estimate extracted | 12 studies · 709 participants | Moderate Downgraded: inconsistency |
Pain (at | no estimate extracted | 5 studies · 357 participants | Moderate Downgraded: inconsistency |
Disability | no estimate extracted | 9 studies · 588 participants | High |
Disability (at | no estimate extracted | 3 studies · 292 participants | High |
Mood | no estimate extracted | 6 studies · 435 participants | Moderate Downgraded: inconsistency |
Mood (at | no estimate extracted | 3 studies · 292 participants | High |