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

Abstract

INTRODUCTION:

Migraine headaches are common in children and adolescents. Current pharmacologic treatment options are limited despite the prevalence and debilitating effects of pediatric migraine. Cognitive behavioral therapy (CBT) is an evidence-based practice that focuses on the development of coping strategies and cognitive restructuring to alter the pain experience. Till date, no meta-analysis has been done to examine the use of CBT in pediatric migraine.

METHODS:

Using the keywords (cognitive behavioral therapy OR cognitive behavior therapy OR cognitive behavioral therapy OR cognitive behavior therapy OR CBT) AND (headache OR migraine), a preliminary search on the PubMed and Ovid database yielded 3841 articles published in English between 1 Jan 1980 and 1 May 2016. Full articles were also reviewed for references of interest. After data extraction, 14 studies were included in the meta-analysis.

RESULTS:

The results of the meta-analysis well-support the clinical role of CBT in the management of pediatric migraine. The pooled odds ratios of clinically significant improvement, that is, 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 < .001) and OR 9.18 (95% CI: 5.69 to 14.81, P < .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 as evident in some of the studies.

CONCLUSION:

There is good evidence that CBT is beneficial to children suffering from migraine, and may also augment the efficacy of standard medications such as amitriptyline.

• Authors: Qin Xiang Ng, Nandini Venkatanarayanan, Lakshmi Kumar
• Journal: Headache (Headache) Vol. 57 Issue 3 Pg. 349-362 (Mar 2017) ISSN: 1526-4610 [Electronic] United States
• PMID: 28028812 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: © 2016 American Headache Society.

Topics

• Adolescent
• Child
• Cognitive Behavioral Therapy (methods)
• Humans
• Longitudinal Studies
• Migraine Disorders (psychology, rehabilitation)
• Pediatrics
• Retrospective Studies