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Sex differences in the efficacy of psychological therapies for the management of chronic and recurrent pain in children and adolescents:a systematic review and meta-analysis


Reference:

Boerner, K. E., Eccleston, C., Chambers, C. T. and Keogh, E., 2017. Sex differences in the efficacy of psychological therapies for the management of chronic and recurrent pain in children and adolescents:a systematic review and meta-analysis. Pain, 158 (4), pp. 569-582.

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    Official URL:

    http://dx.doi.org/10.1097/j.pain.0000000000000803

    Abstract

    Sex differences in chronic pain are reported to emerge during adolescence, although it is unclear if this includes responses to treatment. We conducted a meta-analysis to examine whether sex differences were present on outcome variables at pre-treatment, and whether the efficacy of psychological therapies for pediatric chronic pain differs between boys and girls at post-treatment and follow-up time points. Searches were conducted, extending two existing Cochrane reviews of randomized-controlled trials examining the efficacy of psychological therapies for chronic and recurrent pain in children and adolescents. Forty-six articles were eligible for inclusion, and data were extracted regarding pain, disability, anxiety, and depression in boys and girls at pre-treatment, post-treatment, and follow-up time points. No published study reported outcome data separately by sex, so authors of all studies were contacted and 17 studies provided data. Twice as many girls (n =1760) were enrolled into clinical trials of psychological therapies for pediatric chronic pain than boys (n = 828). Girls reported higher depression and anxiety at pre-treatment than boys. Girls with headache also reported significantly greater pre-treatment pain severity. Treatment gains were consistent across the sexes. One exception was for post-treatment disability in children with non-headache pain conditions; girls exhibited a significant effect of treatment relative to control condition (SMD= -0.50[-0.80,-0.20], p < .01), but no such effect was observed for boys (SMD= -0.08[-0.44,0.28], p = .66). Future research should examine whether mechanisms of treatment efficacy differ between boys and girls, and consider the impact of pre-treatment sex differences on response to treatment.

    Details

    Item Type Articles
    CreatorsBoerner, K. E., Eccleston, C., Chambers, C. T. and Keogh, E.
    DOI10.1097/j.pain.0000000000000803
    DepartmentsFaculty of Humanities & Social Sciences > Health
    Faculty of Humanities & Social Sciences > Psychology
    Research CentresCentre for Pain Research
    RefereedYes
    StatusPublished
    ID Code53755

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