Gulewitsch Marco D, Schlarb Angelika A
aDepartment of Psychology, Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen bDepartment of Psychology, Clinical Psychology and Psychotherapy for Children and Adolescents, Bielefeld University, Bielefeld, Germany.
Eur J Gastroenterol Hepatol. 2017 Dec;29(12):1351-1360. doi: 10.1097/MEG.0000000000000984.
Psychosocial treatments for chronic abdominal pain in childhood or adolescence are effective, but time consuming and hardly available. In the present study, gut-directed hypnotherapy (GDHT) and unspecific hypnotherapy (UHT) were compared to evaluate the feasibility and efficacy of a hypnotherapeutic self-help intervention.
Children/adolescents between 6 and 17 years of age with chronic abdominal pain were randomized to GDHT or UHT. The treatment period was 12 weeks each. Measurements were performed before and after treatment. The primary outcome was a pain diary. Analysis was carried out as per protocol.
Of 45 participants included, 13 were lost to follow-up. Thirty-two participants (14 GHDT, 18 UHT) were analyzed. Dropouts had higher pain severity. Completers in both conditions showed good adherence and a similar decrease in days with pain and pain duration. Pain intensity decreased only in the UHT condition. Eleven participants (two GDHT, nine UHT) achieved clinical remission (>80% improvement) and 13 participants (seven GDHT, six UHT) improved significantly (30-80%).
Results suggest a high efficacy of standardized home-based hypnotherapy for children/adolescents with abdominal pain. Children/adolescents with high pain severity are at risk of dropping out. The UHT condition showed slight evidence of superiority, but conditions were equivalent on most outcomes. Taken together, self-help approaches based on hypnotherapy could close a treatment gap and prevent chronification.
针对儿童或青少年慢性腹痛的心理社会治疗有效,但耗时且难以获得。在本研究中,比较了肠道定向催眠疗法(GDHT)和非特异性催眠疗法(UHT),以评估催眠治疗自助干预的可行性和有效性。
6至17岁患有慢性腹痛的儿童/青少年被随机分配至GDHT或UHT组。治疗期均为12周。在治疗前后进行测量。主要结局是疼痛日记。按照方案进行分析。
纳入的45名参与者中,13名失访。对32名参与者(14名GDHT组,18名UHT组)进行了分析。失访者的疼痛严重程度更高。两种治疗组的完成者均表现出良好的依从性,疼痛天数和疼痛持续时间均有类似程度的减少。仅UHT组的疼痛强度有所下降。11名参与者(2名GDHT组,9名UHT组)实现临床缓解(改善>80%),13名参与者(7名GDHT组,6名UHT组)有显著改善(30%-80%)。
结果表明,标准化的家庭式催眠疗法对患有腹痛的儿童/青少年具有较高疗效。疼痛严重程度高的儿童/青少年有失访风险。UHT组有轻微的优势证据,但在大多数结局指标上两组相当。总体而言,基于催眠疗法的自助方法可以填补治疗缺口并预防病情慢性化。