Viktor Vadenmark Lundqvist, Aleksandra Bujacz, Jenny Rickardsson, Johan Åhlén, Martin Jonsjö, Jörgen Rosén, Sarah Vigerland, Karin Jensen, Marianne Bonnert, Maria Lalouni
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Internet-delivered cognitive-behavioral therapy (iCBT) is effective for FAPDs, but it's unclear whether children with psychiatric comorbidities benefit equally from the treatment.</p><p><strong>Objectives: </strong>In this study, we assessed whether having a comorbid psychiatric diagnosis results in different rates of change in iCBT for children with FAPDs.</p><p><strong>Design: </strong>Between-groups design.</p><p><strong>Methods: </strong>Participants were 120 children with FAPDs (age 8-12 years) taking part in one of two clinical trials testing 10 weeks of iCBT. For the analyses, participants were divided into groups: presence or absence of psychiatric disorder. The primary outcome was gastrointestinal symptoms, assessed weekly using the Pediatric Quality of Life Gastrointestinal Symptom Scale. Secondary outcomes included health-related quality of life, gastrointestinal-specific anxiety, and pain intensity. Multilevel modeling was used to assess differences in rates of change between groups from baseline to follow-up directly after treatment, and then to 6-month follow-up.</p><p><strong>Results: </strong>We observed significant improvements in the rates of change for both groups for the primary outcome (gastrointestinal symptoms) and all secondary outcomes during treatment. Children with psychiatric comorbidity had significantly more severe symptoms at baseline on all measures, but there was no difference in the rates of change for the primary outcome (-0.29, 95% confidence interval (CI): -0.70, 0.11, <i>p</i> = 0.159) or any of the secondary outcomes compared to the non-comorbid group. Treatment benefits were sustained at 6-month follow-up.</p><p><strong>Conclusion: </strong>ICBT seems to be beneficial for children with FAPDs, also in the presence of psychiatric comorbidity. Given the high prevalence of psychiatric comorbidity in this patient group, the results will aid the clinical assessment and treatment planning for these patients.</p>","PeriodicalId":48770,"journal":{"name":"Therapeutic Advances in Gastroenterology","volume":"18 ","pages":"17562848251384605"},"PeriodicalIF":3.4000,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12515282/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparing the treatment effects of online cognitive-behavioral therapy for pediatric functional abdominal pain disorders with and without psychiatric comorbidity.\",\"authors\":\"Viktor Vadenmark Lundqvist, Aleksandra Bujacz, Jenny Rickardsson, Johan Åhlén, Martin Jonsjö, Jörgen Rosén, Sarah Vigerland, Karin Jensen, Marianne Bonnert, Maria Lalouni\",\"doi\":\"10.1177/17562848251384605\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Functional abdominal pain disorders (FAPDs) are disorders of the gut-brain interaction. FAPDs are common in children and adolescents (global prevalence 12%) and are associated with psychiatric comorbidity. Internet-delivered cognitive-behavioral therapy (iCBT) is effective for FAPDs, but it's unclear whether children with psychiatric comorbidities benefit equally from the treatment.</p><p><strong>Objectives: </strong>In this study, we assessed whether having a comorbid psychiatric diagnosis results in different rates of change in iCBT for children with FAPDs.</p><p><strong>Design: </strong>Between-groups design.</p><p><strong>Methods: </strong>Participants were 120 children with FAPDs (age 8-12 years) taking part in one of two clinical trials testing 10 weeks of iCBT. For the analyses, participants were divided into groups: presence or absence of psychiatric disorder. The primary outcome was gastrointestinal symptoms, assessed weekly using the Pediatric Quality of Life Gastrointestinal Symptom Scale. Secondary outcomes included health-related quality of life, gastrointestinal-specific anxiety, and pain intensity. Multilevel modeling was used to assess differences in rates of change between groups from baseline to follow-up directly after treatment, and then to 6-month follow-up.</p><p><strong>Results: </strong>We observed significant improvements in the rates of change for both groups for the primary outcome (gastrointestinal symptoms) and all secondary outcomes during treatment. Children with psychiatric comorbidity had significantly more severe symptoms at baseline on all measures, but there was no difference in the rates of change for the primary outcome (-0.29, 95% confidence interval (CI): -0.70, 0.11, <i>p</i> = 0.159) or any of the secondary outcomes compared to the non-comorbid group. Treatment benefits were sustained at 6-month follow-up.</p><p><strong>Conclusion: </strong>ICBT seems to be beneficial for children with FAPDs, also in the presence of psychiatric comorbidity. 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引用次数: 0
摘要
背景：功能性腹痛障碍（FAPDs）是肠脑相互作用的障碍。fapd在儿童和青少年中很常见（全球患病率为12%），并与精神合并症有关。互联网提供的认知行为疗法（iCBT）对fapd有效，但目前尚不清楚患有精神疾病的儿童是否同样受益于这种治疗。目的：在本研究中，我们评估了患有精神科共病诊断是否会导致fapd儿童iCBT的不同变化率。设计：组间设计。方法：参与者为120名FAPDs儿童（8-12岁），参加了两项临床试验中的一项，测试10周的iCBT。为了进行分析，参与者被分为两组：存在或不存在精神障碍。主要终点是胃肠道症状，每周使用儿科生活质量胃肠道症状量表进行评估。次要结局包括与健康相关的生活质量、胃肠道特异性焦虑和疼痛强度。采用多水平模型评估各组之间从基线到治疗后直接随访，再到6个月随访的变化率差异。结果：我们观察到两组在治疗期间的主要结局（胃肠道症状）和所有次要结局的变化率均有显著改善。在所有的基线测量中，有精神疾病共病的儿童有更严重的症状，但与无共病组相比，主要结局（-0.29,95%可信区间（CI）： -0.70, 0.11, p = 0.159）或任何次要结局的变化率没有差异。在6个月的随访中，治疗效果持续。结论：ICBT似乎对fapd儿童有益，也对存在精神合并症的儿童有益。鉴于该患者群体中精神疾病的高发性，该结果将有助于这些患者的临床评估和治疗计划。
Comparing the treatment effects of online cognitive-behavioral therapy for pediatric functional abdominal pain disorders with and without psychiatric comorbidity.
Background: Functional abdominal pain disorders (FAPDs) are disorders of the gut-brain interaction. FAPDs are common in children and adolescents (global prevalence 12%) and are associated with psychiatric comorbidity. Internet-delivered cognitive-behavioral therapy (iCBT) is effective for FAPDs, but it's unclear whether children with psychiatric comorbidities benefit equally from the treatment.
Objectives: In this study, we assessed whether having a comorbid psychiatric diagnosis results in different rates of change in iCBT for children with FAPDs.
Design: Between-groups design.
Methods: Participants were 120 children with FAPDs (age 8-12 years) taking part in one of two clinical trials testing 10 weeks of iCBT. For the analyses, participants were divided into groups: presence or absence of psychiatric disorder. The primary outcome was gastrointestinal symptoms, assessed weekly using the Pediatric Quality of Life Gastrointestinal Symptom Scale. Secondary outcomes included health-related quality of life, gastrointestinal-specific anxiety, and pain intensity. Multilevel modeling was used to assess differences in rates of change between groups from baseline to follow-up directly after treatment, and then to 6-month follow-up.
Results: We observed significant improvements in the rates of change for both groups for the primary outcome (gastrointestinal symptoms) and all secondary outcomes during treatment. Children with psychiatric comorbidity had significantly more severe symptoms at baseline on all measures, but there was no difference in the rates of change for the primary outcome (-0.29, 95% confidence interval (CI): -0.70, 0.11, p = 0.159) or any of the secondary outcomes compared to the non-comorbid group. Treatment benefits were sustained at 6-month follow-up.
Conclusion: ICBT seems to be beneficial for children with FAPDs, also in the presence of psychiatric comorbidity. Given the high prevalence of psychiatric comorbidity in this patient group, the results will aid the clinical assessment and treatment planning for these patients.
期刊介绍：
Therapeutic Advances in Gastroenterology is an open access journal which delivers the highest quality peer-reviewed original research articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of gastrointestinal and hepatic disorders. The journal has a strong clinical and pharmacological focus and is aimed at an international audience of clinicians and researchers in gastroenterology and related disciplines, providing an online forum for rapid dissemination of recent research and perspectives in this area.
The editors welcome original research articles across all areas of gastroenterology and hepatology.
The journal publishes original research articles and review articles primarily. Original research manuscripts may include laboratory, animal or human/clinical studies – all phases. Letters to the Editor and Case Reports will also be considered.
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