A randomized controlled trial of Internet-based self-help training for recurrent headache in childhood and adolescence
A randomized controlled trial of Internet-based self-help training for recurrent headache in childhood and adolescence
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DOI：
10.1016/j.brat.2009.09.004
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发表时间：
2010-01-01
影响因子：
4.1
通讯作者：
Kroener-Herwig, Birgit
中科院分区：
文献类型：
--
作者：
Trautmann, Ellen;Kroener-Herwig, Birgit
两种不同的自助培训计划（多模式认知行为训练（CBT）和应用放松（AR））通过互联网进行了比较，教育干预（EDU）的随机对照试验。65名患有复发性头痛（每月至少发作2次）的儿童和青少年（平均年龄：12.7岁）分别被分配到三种治疗条件之一。主要结果变量与头痛频率、强度和持续时间的变化以及应答率（头痛频率降低50%）和NNT相关。次要结局变量为疼痛灾难化和总体健康状况（抑郁、精神病理学症状和健康相关生活质量）。在评估后，所有组的头痛频率、持续时间和疼痛灾难性均显着减少，但头痛强度、抑郁、精神病理学症状或健康相关生活质量均无显着减少。治疗后CBT和EDU比较的NNT为2.0; AR和EDU比较的NNT为5.2。治疗后CBT的应答率最高（63%），与AR（32%）和EDU（19%）相比有显著差异，而在随访时，NNTs的应答率无显著差异（CBT：63%，AR：56%，EDU：55%）。CBT在头痛频率、持续时间和疼痛灾难化方面显示出最高的内效应量。研究结果支持使用互联网程序治疗儿童复发性头痛，特别是考虑到其可访问性和适用性，儿童和青少年。需要进一步研究以提高其质量和功效。(C)2009爱思唯尔有限公司版权所有。
Two different self-help training programs (multimodal cognitive-behavioral training (CBT) and applied relaxation (AR)) presented via the Internet were compared with an educational intervention (EDU) in an RCT. Sixty-five children and adolescents (mean age: 12.7 years) with recurrent headache (at least 2 attacks per month) were each assigned to one of the three treatment conditions. The main outcome variables related to changes in headache frequency, intensity and duration as well as the responder rate (50% reduction of headache frequency) and NNTs. Secondary outcome variables were pain catastrophizing and general well-being (depression, psychopathological symptoms and health-related quality of life). All groups showed significant reduction in headache frequency, duration and pain catastrophizing, but not in headache intensity, depression, psychopathological symptoms or health-related quality of life at post-assessment. NNTs were 2.0 for the comparison CBT and EDU; 5.2 for the comparison of AR and EDU at post-treatment. The highest responder rates at post were from CBT (63%), significantly different compared to AR (32%) and EDU (19%), whereas at follow-up no significant differences were found (CBT: 63%, AR: 56%, EDU: 55%) reflecting in the NNTs.The effects remain stable in headache frequency, pain catastrophizing and psychopathological symptoms across all groups at follow-up assessment. CBT showed the highest within-effect size in headache frequency, duration and pain catastrophizing. The results support the use of Internet programs for pediatric recurrent headache, especially given their accessibility and suitability for children and adolescents. Further studies are needed to improve their quality and efficacy. (C) 2009 Elsevier Ltd. All rights reserved.