A cognitive-behavioral therapy approach in managing pediatric migraine

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A cognitive-behavioral therapy approach in managing pediatric migraine

A new study suggests that cognitive-behavioral therapy (CBT), a popular form of psychotherapy could help children and teens suffering from chronic migraine. Cognitive behavioral therapy shows great promise for migraineurs and reduces the frequency of attacks without any side effects.

Migraine refers to frequent recurring episodes of severe pulsating headaches with accompanying symptoms like nausea, vomiting, and sensitivity to light and sound. The majority of children with this disorder experience impairment in their ability to function at school and to participate in physical and social activities.   

The CBT uses an evidence-based coping skills protocol to relieve pain in pediatric population. However, no meta-analysis has been conducted to examine the use of CBT in pediatric migraine. Thus, this meta-analytic review examined the effectiveness of CBT in the treatment of migraine in children and adolescents. Literature search were executed using database such as Ovid and Pubmed, and the search terms employed were cognitive behavioral therapy OR cognitive behavior therapy OR CBTAND (headache OR migraine) which yielded 3841 articles published in English. Researchers did search between 1 Jan 1980 and 1 May 2016. Full-text articles were reviewed for references of interest.

Total 14 studies examined CBT for pediatric migraine. Outcome measures included child reported pain intensity, pain duration and functional disability. Overall, meta-analyses strongly support the effectiveness of CBT in the management of pediatric migraine. The pooled odds ratios of clinically significant improvement was 50% or greater headache activity reduction post-treatment and at follow-up (3 months or later) were OR 9.11 (95% CI: 5.01 to 16.58, p<0.001) and OR 9.18 (95% CI: 5.69 to 14.81, p<0.001) respectively, demonstrating significant clinical improvement with CBT as compared with wait-list control, placebo, or standard medication. Furthermore, the clinical improvement was stable, even at a 1-year follow-up.

The findings of this review provide good evidence supporting that children and adolescents experiencing headaches or migraines can benefit from CBT, and  may also increase the efficacy of standard medications like amitriptyline.

Source:

Headache: The journal of head and face pain

Link to the source:

http://www.onlinelibrary.wiley.com/doi/10.1111/head.13016/abstract

Original title of article:

A Systematic Review and Meta-Analysis of the Efficacy of Cognitive Behavioral Therapy for the Management of Pediatric Migraine

Authors:

Qin Xiang Ng et al.

 
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