Clinical features, anger management and anxiety: a possible correlation in migraine children

Abstract

BackgroundPsychological factors can increase severity and intensity of headaches. While great attention has been placed on the presence of anxiety and/or depression as a correlate to a high frequency of migraine attacks, very few studies have analyzed the management of frustration in children with headache. Aim of this study was to analyze the possible correlation between pediatric migraine severity (frequency and intensity of attacks) and the psychological profile, with particular attention to the anger management style.MethodsWe studied 62 migraineurs (mean age 11.2 ± 2.1 years; 29 M and 33 F). Patients were divided into four groups according to the attack frequency (low, intermediate, high frequency, and chronic migraine). Pain intensity was rated on a 3-levels graduate scale (mild, moderate and severe pain). Psychological profile was assessed by Picture Frustration Study test for anger management and SAFA-A scale for anxiety.ResultsWe found a relationship between IA/OD index (tendency to inhibit anger expression) and both attack frequency (r = 0.328, p = 0.041) and intensity (r = 0.413, p = 0.010). When we analyzed the relationship between anxiety and the headache features, a negative and significant correlation emerged between separation anxiety (SAFA-A Se) and the frequency of attacks (r = −0.409, p = 0.006). In our patients, the tendency to express and emphasize the presence of the frustrating obstacle (EA/OD index) showed a positive correlation with anxiety level (“Total anxiety” scale: r = 0.345; p = 0.033).ConclusionsOur results suggest that children suffering from severe migraine tend to inhibit their angry feelings. On the contrary, children with low migraine attack frequency express their anger and suffer from separation anxiety.

The role of attachment insecurity in the emergence of anxiety symptoms in children and adolescents with migraine: an empirical study

“…More specifically, our findings replicated previous reports of associations between headache and GAD [30], SAD [31], SA [32–34] and SLA [21, 23] in children and adolescents. Analysis revealed differences between the clinical and control groups with respect to security of attachment to both parental figures.…”

Neuropsychiatric comorbidity among adolescents with psoriasis

“…Chronic headaches were further subclassified into: (i) intermediate‐frequency migraine, (ii) low‐frequency migraine or nonmigraine chronic headaches. The migraine frequency scale was in accordance with previous migraine studies, carried out with both adults and children …”

Role of the Attachment Style in Determining the Association Between Headache Features and Psychological Symptoms in Migraine Children and Adolescents. An Analytical Observational Case–Control Study

“…Several studies have showed a relationship between anxiety, depression, and migraine severity, especially in pediatric age . These psychological symptoms are often considered as factors of migraine chronification but, on the other hand, may also represent a psychological reaction to recurrent and severe migraine attacks .…”

“…36 Does the Attachment Style Play a Role in the Association Between Psychological Profile and Migraine Severity?-Several studies have showed a relationship between anxiety, depression, and migraine severity, especially in pediatric age. 1,37,38 These psychological symptoms are often considered as factors of migraine chronification but, on the other hand, may also represent a psychological reaction to recurrent and severe migraine attacks. 3,4 The nature of this relationship remains unclear.…”