Department of Gastroenterology, Hepatology, and Nutrition, Children's Medical Center Dallas, Children's Health, Department of Psychiatry, University of Texas Southwestern (UTSW), Dallas, Texas, USA.
Curr Opin Pediatr. 2022 Oct 1;34(5):516-520. doi: 10.1097/MOP.0000000000001161. Epub 2022 Aug 22.
The purpose of this review is to discuss up-to-date psychological treatment strategies for functional abdominal pain disorders (FAPDs) with practical implications for primary care providers who are the "front line" of treatment for pediatric FAPD.
Positive diagnosis, pain education, and access to multidisciplinary care improve outcomes for FAPD patients. Cognitive behavioral therapy (CBT) and hypnosis continue to have the strongest evidence in psychological treatments, but educational interventions and other nonpharmacological approaches show promise as well. There are innovative programs that combine these tools into group or internet-based treatments to expand access to care. Additionally, nonpharmacological tools, including neurostimulation and virtual reality programs, are increasing in popularity.
FAPD is prevalent across pediatric practices, yet there is no standard medical or dietary approach, and there are many barriers to diagnosis and treatment. It is important for patients to have positive encounters around diagnosis and education, access to multidisciplinary care, and integrated psychological support. Consistently, studies show that psychology continues to be a vital component of care. This review discusses supported uses of psychology, innovative programming for increasing access to care, and how primary care providers can incorporate lessons learned from psychology in FAPD care.
本文旨在讨论功能性腹痛障碍(FAPD)的最新心理治疗策略,为作为儿科 FAPD 治疗“第一线”的初级保健提供者提供实际意义。
阳性诊断、疼痛教育和获得多学科治疗可改善 FAPD 患者的预后。认知行为疗法(CBT)和催眠仍然是心理治疗中最有力的证据,但教育干预和其他非药物方法也显示出希望。有一些创新的项目将这些工具结合到小组或基于互联网的治疗中,以扩大治疗的可及性。此外,包括神经刺激和虚拟现实程序在内的非药物工具越来越受欢迎。
FAPD 在儿科实践中普遍存在,但没有标准的医疗或饮食方法,诊断和治疗存在许多障碍。患者在诊断和教育方面有积极的体验、获得多学科治疗以及整合心理支持非常重要。一致的是,研究表明,心理学仍然是治疗的重要组成部分。本文讨论了支持使用心理学、增加治疗可及性的创新方案,以及初级保健提供者如何将从心理学中获得的经验教训应用于 FAPD 护理中。