WHAT'S KNOWN ON THIS SUBJECT: Pediatric functional abdominal pain is common and costly. Cognitive behavior therapy (CBT) is a promising treatment for these complaints, but solid evidence for its effectiveness is lacking. WHAT THIS STUDY ADDS:This randomized controlled trial shows that CBT reduces abdominal pain in 60% of children 1 year after treatment. Six sessions of CBT delivered by trained master' s students in psychology were equally effective as 6 visits to an experienced pediatrician. abstract OBJECTIVE: This randomized controlled trial investigated the effectiveness of a 6-session protocolized cognitive behavior therapy (CBT) compared with 6 visits to a pediatrician (intensive medical care; IMC) for the treatment of pediatric functional abdominal pain (FAP). METHODS:One hundred four children aged 7 to 18 were randomized to CBT or IMC. CBT was delivered primarily by trained master' s degree students in psychology; IMC was delivered by pediatricians or pediatric gastroenterologists. Assessments were performed pretreatment, posttreatment, and at 6-and 12-month follow-up. Primary outcomes were level of abdominal pain (AP) as reported on questionnaires and diaries. Secondary outcomes were other gastrointestinal complaints, functional disability, other somatic complaints, anxiety, depression, and quality of life.RESULTS: Both CBT and IMC resulted in a significant decrease in AP (P , .001), but no significant difference was found between the treatments in their effectiveness (P . .05 for all end points). According to the questionnaire-derived data, 1 year after treatment, 60% of children that received CBT had significantly improved or recovered, versus 56.4% of children receiving IMC, which did not significantly differ (P = .47). These percentages were 65.8% versus 62.8% according to the diary-derived data, which also did not significantly differ (P = .14). Additionally, nearly all secondary outcomes improved after treatment.CONCLUSIONS: CBT was equally effective as IMC in reducing AP in children with FAP. More research into the specific working mechanisms of CBT for pediatric FAP is needed.

Background Obesity is a growing problem even in very young childhood, resulting in high costs for individuals and society. As a response, numerous obesity prevention and intervention programs have been developed. Previous research has shown that early intervention programs are more effective when parents are involved, but the effectiveness of specific aspects of programs with parental involvement has not been investigated. This meta‐analysis aims to investigate the features related to the effectiveness of different types of obesity intervention programs involving parents and targeting young children (0–6‐year‐olds). Methods The Web of Science, PubMed, PsycInfo, CINAHL, and ERIC databases were searched for childhood obesity prevention and intervention programs involving parents. Data were analyzed using the Comprehensive Meta‐analysis (CMA) software. Results Fifty studies with effect sizes measured at short‐term follow‐up (within 3 months from the end of the intervention) and 26 studies with effect sizes measured at long‐term follow‐up (all reported in a total of 49 publications) were identified. The combined effect size of interventions was small but significant at short‐term follow‐up (d = .08, p < .01). The results suggested the presence of a potential publication bias in studies providing results at long‐term follow‐up, with a nonsignificant adjusted effect size (d = .02), which indicated that obesity interventions were not effective at long‐term follow‐up. Multivariate meta‐regression analyses showed that interventions were more effective when including either interactive sessions or educational materials as opposed to those including both interactive sessions and noninteractive educational materials. No other moderators regarding sample characteristics, study design, or methodological quality were significant. Conclusion Interventions targeting young children that require parental involvement are effective at short‐term follow‐up, specifically when interventions include one mode of intervention rather than two. However, results were not retained in the long run.

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