Psychological Interventions for Children with Functional Somatic Symptoms: A Systematic Review and Meta-Analysis

Irma J Bonvanie, Karen H Kallesøe, Karin A M Janssens, Andreas Schröder, Judith G M Rosmalen, Charlotte U Rask

Research output: Contribution to journalReview articlepeer-review

24 Citations (Scopus)

Abstract

Objective: To analyze the effectiveness of psychological treatments on symptom load and associated disability in children with functional somatic symptoms, and to explore potential moderators of effects.

Study design: Cochrane, PubMed, PsycINFO, EMBASE, and CINAHL were searched for randomized controlled trials published in peer-reviewed journals. Randomized controlled trials studying the effect of a psychological treatment on symptom load and disability in children with functional somatic symptoms were selected. Data on symptom load, disability, and school absence directly post-treatment and at follow-up were extracted by 2 assessors. Studies were appraised with the Cochrane risk of bias tool. Standardized mean differences were pooled in a random-effects model. Heterogeneity in effect-sizes was explored by use of meta-regressions. PROSPERO Registration ID: CRD42015029667.

Results: Out of 4098 identified records, 27 studies were included in this review of which 21 were included in meta-analyses. Psychological treatments reduced symptom load (Hedges g = -0.61), disability (Hedges g = -0.42), and school absence (Hedges g = -0.51) post-treatment in children suffering from various functional somatic symptoms. Effects were maintained at follow-up. Type and duration of symptoms, age, and treatment dose did not explain heterogeneity in effect-sizes between studies. Effect-sizes should be interpreted with caution because of the variety in outcome measures, unexplained heterogeneity in found effects and potential publication bias.

Conclusions: Psychological interventions reduce symptom load, disability, and school absence in children with functional somatic symptoms. Future research should clarify which patient and treatment characteristics modify outcomes.

Original languageEnglish
Pages (from-to)272-281.e17
Number of pages27
JournalThe Journal of Pediatrics
Volume187
Early online date14-Apr-2017
DOIs
Publication statusPublished - Aug-2017

Keywords

  • CHRONIC-FATIGUE-SYNDROME
  • RANDOMIZED CONTROLLED-TRIAL
  • RECURRENT ABDOMINAL-PAIN
  • COGNITIVE-BEHAVIORAL THERAPY
  • IRRITABLE-BOWEL-SYNDROME
  • TERM-FOLLOW-UP
  • EMPIRICALLY SUPPORTED TREATMENTS
  • GUT-DIRECTED HYPNOTHERAPY
  • TENSION-TYPE HEADACHE
  • SOMATIZATION INVENTORY

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