Department of Clinical Psychology and Psychotherapy, University of Göttingen, Germany.
Behav Res Ther. 2010 Jan;48(1):28-37. doi: 10.1016/j.brat.2009.09.004. Epub 2009 Sep 10.
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.
两种不同的自助训练计划（多模态认知行为训练（CBT）和应用放松（AR））通过互联网进行比较，与一项 RCT 中的教育干预（EDU）进行比较。65 名患有复发性头痛（每月至少 2 次发作）的儿童和青少年（平均年龄：12.7 岁）被分配到三种治疗条件之一。主要的结局变量与头痛频率、强度和持续时间的变化以及反应率（头痛频率减少 50%）和 NNTs 有关。次要结局变量是疼痛灾难化和一般幸福感（抑郁、心理病理症状和健康相关生活质量）。所有组在头痛频率、持续时间和疼痛灾难化方面均显示出显著降低，但头痛强度、抑郁、心理病理症状或健康相关生活质量在评估后没有显著降低。NNTs 为 CBT 和 EDU 比较的 2.0；AR 和 EDU 比较的 5.2。治疗后反应率最高的是 CBT（63%），与 AR（32%）和 EDU（19%）相比差异显著，而随访时则无显著差异（CBT：63%，AR：56%，EDU：55%），反映在 NNTs 中。在随访评估时，所有组的头痛频率、疼痛灾难化和心理病理症状的效果均保持稳定。CBT 在头痛频率、持续时间和疼痛灾难化方面表现出最高的内效大小。结果支持使用互联网程序治疗儿科复发性头痛，尤其是考虑到其可及性和对儿童和青少年的适用性。需要进一步研究来提高它们的质量和效果。
