Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller Institute of Psychology, Georg-August-University of Göttingen, Göttingen, Germany.
Expert Rev Neurother. 2011 Mar;11(3):403-10. doi: 10.1586/ern.11.10.
Headache is the most common pain problem in children and adolescents and, in a considerable proportion, a source of suffering and disability. Medical intervention mainly relies on abortive pharmacological agents (analgesics and antimigraine drugs). Psychological therapies aim at the prevention of headache episodes and the modifications of cognitive-emotional and cognitive-behavioral processes influencing pain. Three main forms of therapy have been evaluated in randomized controlled trials and reviewed in meta-analyses: relaxation training, biofeedback and multimodal cognitive-behavioral therapy. So far there is only scarce evidence on hypnosis and acceptance and commitment therapy, although they seem to be promising. Evidence demonstrates that psychological therapies are efficacious, and that clinically relevant improvement is found in approximately 70% of the treated children at follow-up examination. Future research needs to focus on mechanisms of change, and to extend its view of effects induced by therapy beyond headache improvement to indicators of quality of life.
头痛是儿童和青少年最常见的疼痛问题，相当一部分患者因此遭受痛苦和残疾。医学干预主要依赖于治标不治本的药物（镇痛药和抗偏头痛药）。心理疗法旨在预防头痛发作，并改变影响疼痛的认知-情绪和认知-行为过程。在随机对照试验中已经评估了三种主要的治疗形式，并在荟萃分析中进行了综述：放松训练、生物反馈和多模式认知行为疗法。到目前为止，催眠和接受与承诺疗法的证据还很少，尽管它们似乎很有前途。证据表明，心理疗法是有效的，在随访检查中，大约 70%的接受治疗的儿童有临床相关的改善。未来的研究需要集中在变化机制上，并将治疗引起的效果的视角从头痛改善扩展到生活质量指标。
