Short-Term and Long-Term Effectiveness of Intensive Interdisciplinary Pain Treatment for Children and Adolescents with Chronic Headache: A Longitudinal Observation Study.

Meltem Dogan,Julia Wager,Boris Zernikow

doi:10.3390/children8030220

Abstract

Pediatric chronic headache causes significant impairment to those affected and bears the risk of aggravation into adulthood. Intensive interdisciplinary pain treatment (IIPT) was found to positively affect pain-related and emotional outcomes in pediatric patients with chronic pain up to 4 years after treatment. This study was aimed at investigating the effect of IIPT on solely pediatric chronic headache patients. As part of a longitudinal observation study, n = 70 children and adolescents with chronic headache receiving IIPT were included, of which n = 47 completed the assessment at four assessment time points: before treatment (PRE) and at three follow-ups (6-MONTH FOLLOW-UP, 1-YEAR FOLLOW-UP, and 4-YEAR FOLLOW-UP). Pain-related (pain intensity, pain-related disability, school absence), as well as psychological outcome domains (anxiety, depression), were investigated. The results support the short-term and long-term efficacy of IIPT for pediatric chronic headache patients regarding the pain-related outcome measures by significant reductions from PRE to all follow-up measure points. For anxiety and depression, only short-term improvements were found. Future studies should specifically focus on the identification of methods to consolidate the beneficial short-term effects of IIPT on psychological outcome domains in the long term.

Highlights

Severe chronic pain in children and adolescents is a highly impairing health condition, for the 5% to 8% of children severely affected [1,2], and for their families and society as a whole [3,4]
The six-month follow-up data demonstrated that short-term improvement was found in all pain-related and psychological parameters; patients suffered from less intense pain and less pain-related disability, while they attended school more frequently and indicated lower levels of depression and anxiety
Regarding the long-term effects of interdisciplinary pain treatment (IIPT), there was a beneficial decline in painrelated outcome parameters; four years after IIPT, patients again reported less pain-related disability, pain intensity, and school absence

Summary

Introduction

Severe chronic pain in children and adolescents is a highly impairing health condition, for the 5% to 8% of children severely affected [1,2], and for their families and society as a whole [3,4]. More than one-third of adolescents with chronic pain experience headaches, making this pain location the most prevalent after lower limb pain (41%) [1]. Children and adolescents with chronic headaches were found to be more likely to experience more severe chronic pain syndromes than those with other pain locations [2]. The majority (60%) of pediatric headache patients report medication overuse and show significantly more symptoms of anxiety, depression, and somatization compared with healthy controls [5]

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Discussion

Conclusion