Emotional and Behavioural Problems in Children and Adolescents with Primary Headache

Just, U; Oelkers, R; Bender, Stephan; Parzer, Peter; Ebinger, Friedrich; Weisbrod, Matthias; Resch, Franz

doi:10.1046/j.1468-2982.2003.00486.x

Cited by 78 publications

(109 citation statements)

References 51 publications

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“…Just et al (35) asserted that children and adolescents with primary headaches suffer more often from internalizing problems, depression, anxiety and somatization than do controls. They suggested that psychiatric comorbidity is an important risk factor for chronic primary headaches in adulthood.…”

Section: Fig 1 the Risk Analysis For Anxiety Or Depression Which Ismentioning

confidence: 99%

Primary Headaches in Children: Clinical Findings and the Association with other Conditions

Pavone

Rizzo

Conti

et al. 2012

Int J Immunopathol Pharmacol

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The aim of the present study is to report on the frequency of some comorbidities in primary headaches in childhood. Two hundred and eighty children (175 males and 105 females; ratio 1.7:1), aged 4 to 14 years, affected by primary headaches were consecutively enrolled in this study. In direct interviews, parents and children gave information about the association of their headaches with different conditions including asthma and allergic disorders, convulsive episodes, sleep disorders and increased body weight, affections some time associated in the literature to headache as comorbidities . In addition, anxiety and depression, attention deficitlhyperactivity disorder, tics, learning disabilities and obsessive-compulsive disorders, using psycho-diagnostic scales were evaluated. Two hundred and eighty children matched for age, sex, race and socio-economic status; were used as controls. No significant association of primary headaches was found with asthma and allergic disorders, convulsive episodes, sleep disorders and increased body weight. Overall behavioral disorders were more common in children who experienced headache than in controls. A significant association of primary headache was found with anxiety and depression (p value <0.001), but not with the other psychiatric disorders. Primary headaches in children are not associated with most of the psychiatric and systemic conditions herein investigated. On the contrary, there was a significant association with anxiety and depression, as frequently reported in adults.Recurrent headaches are very widespread and disabling conditions in children. Although most cases follow a benign course, they cause substantial worry in parents and caregivers. The diagnosis of primary and secondary headache disorders is based upon the history of headaches, a careful physical and neurological examination, and in some cases, neurological investigations.Recurrent, episodic and paroxysmal attacks are suggestive of primary headache disorders, which have been subdivided into migraines, tension-type headaches (TTHs), cluster headaches, and other (uncommon) types in children. Migraines are further subdivided into migraines with and without auras, complicated migraines and migraine variants (1-3). Migraines have been estimated to affect nearly 75% of children under the age of 15 years and have been reported in 3.9% of children between the ages of 7 and 15 years, with a range from 1.7% in 7-yearold children to 5% in l5-year-old children (3-4).

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Section: Fig 1 the Risk Analysis For Anxiety Or Depression Which Ismentioning

confidence: 99%

Primary Headaches in Children: Clinical Findings and the Association with other Conditions

Pavone

Rizzo

Conti

et al. 2012

Int J Immunopathol Pharmacol

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“…22 Indeed, several mental health problems of this kind appear to commonly be present in migraine, including stress, anxiety, depression, somatization and panic disorder. [23][24][25][26] For example, a two-to six-fold increased risk for anxiety disorders has been shown for migraine, 27 and there is a high prevalence of major depression in migraine. 24,28,29 Stress plays the role of an important triggering factor for acute migraine attacks 29 and seems to regulate the maintenance of the disorder, the regularity of the attacks, 30 and the change from episodic to chronic state.…”

mentioning

confidence: 99%

“…[23][24][25][26] For example, a two-to six-fold increased risk for anxiety disorders has been shown for migraine, 27 and there is a high prevalence of major depression in migraine. 24,28,29 Stress plays the role of an important triggering factor for acute migraine attacks 29 and seems to regulate the maintenance of the disorder, the regularity of the attacks, 30 and the change from episodic to chronic state. 31 Although studies appear to be lacking in the literature, it is likely that the high stress level in migraine, if sustained, and with the additional impact of anxiety and depression, will result in burnout and a diagnosis of exhaustion syndrome.…”

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confidence: 99%

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Comorbidity in Migraine with Functional Somatic Syndromes, Psychiatric Disorders and Inflammatory Diseases: A Matter of Central Sensitization?

Grassini

Nordin

2015

Behavioral Medicine

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To approach the questions as to why migraine appears to be associated with functional somatic syndromes (FSSs) and whether central sensitization may be an underlying mechanism, the present study investigated (a) comorbidity with diagnoses of three FSSs, three psychiatric disorders, and three inflammatory diseases, (b) degree of mental health problems (stress, burnout, anxiety, depression and somatization), and (c) prevalence of ten cognitive/affective and nine airway symptoms in persons with migraine in the general population. From a randomized and stratified Swedish adult sample, questionnaire data were analyzed from 151 individuals with a diagnosis of migraine and 3,255 without migraine. The results showed (a) significant comorbidity in migraine with all FSSs, psychiatric disorders and inflammatory diseases, (b) significantly elevated scores on stress, burnout, anxiety, depression, and somatization, and (c) relatively high prevalence rates on almost all symptoms. Taken together, the results motivate future study of central sensitization as a mechanism underlying migraine.

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“…Despite the fact that over the years it has been increasingly studied, the relationship between headache and psychopathology remains poorly understood and it is still controversial [24] . Some literature fi ndings suggest the presence of specifi c personality traits [23] and psychiatric disorders (mainly anxiety and mood disorders) in headache sufferers [24][25][26] . However two thirds of headache children do not seem to present a clinically relevant psychopathology even if subclinical psychological disorders may occur [26] .…”

Section: Discussionmentioning

confidence: 99%

The Effectiveness of Hospitalization in the Treatment of Paediatric Idiopathic Headache Patients

et al. 2006

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Background: Headache is a disease that has a high social impact in the paediatric as well as in the adult population, often resulting in a significant reduction in the young patient’s quality of life, reflected primarily in a greater number of days off school and increasingly frequent recourse to symptomatic drugs. The idea for this study came from the clinical impression that some paediatric headache patients might benefit more from inpatient than outpatient care. Aim: The aim of our study was to compare the effectiveness of hospitalization to outpatient care of patients with newly diagnosed frequent and disabling headache. Methods: A pragmatic randomized open-label trial was conducted at the Child Neurology Clinic of the University of Pavia, Italy. Children and adolescents with a 2- to 6-month moderate-to-severe migraine or tension-type headache history were randomized to hospital admission or outpatient assessment and followed for 6 months. The efficacy of the two therapeutic strategies was measured by counting the number of responders in each arm. Other end points included the mean frequency and duration of attacks, the number of drug prescriptions taken to control pain, and the number of patients and physicians expressing satisfaction with treatment. Results: The study population included 27 girls and 23 boys aged 8 through 18 years with migraine (23 cases) or tension-type headache (27 cases). Compared to outpatient assessment, hospital admission was correlated to a significant increase in the number of responders: 0 vs. 44% (1 month), 0 vs. 68% (3 months), and 12 vs. 68% (6 months). The mean frequency and duration of attacks were significantly lower in hospitalized patients (p < 0.0001). Hospitalization was correlated with a significant reduction of patients with severe headache (p < 0.005), a reduction of drug use, and a higher number of satisfied patients and physicians (p < 0.05). Logistic regression analysis confirmed the higher responder rate among hospitalized patients after adjusting for age, sex, diagnosis, and headache characteristics or admission. Conclusions: We think hospitalization reduces the emotional mechanisms that provoke stress in children and often induce or favour headache attacks. If these mechanisms can be interrupted, the management of disease may become easier and with enduring benefits.

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Emotional and Behavioural Problems in Children and Adolescents with Primary Headache

Cited by 78 publications

References 51 publications

Primary Headaches in Children: Clinical Findings and the Association with other Conditions

Primary Headaches in Children: Clinical Findings and the Association with other Conditions

Comorbidity in Migraine with Functional Somatic Syndromes, Psychiatric Disorders and Inflammatory Diseases: A Matter of Central Sensitization?

The Effectiveness of Hospitalization in the Treatment of Paediatric Idiopathic Headache Patients

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