Headache and comorbidity in children and adolescents

Bellini, Benedetta; Arruda, Marco A.; Cescut, Alessandra; Saulle, Cosetta; Persico, Antonio M.; Carotenuto, Marco; Gatta, Michela; Nacinovich, Renata; Piazza, F; Termine, Cristiano; Tozzi, E.; Lucchese, Franco; Guidetti, Vincenzo

doi:10.1186/1129-2377-14-79

Cited by 162 publications

(134 citation statements)

References 108 publications

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“…13 Factores de risco ambientais como o consumo de substâncias, traumatismos cranianos, perturbação do padrão de sono e coexistência de enxaqueca, aumentam o risco para o desenvolvimento de crises de cefaleia em salvas. As perturbações do sono, nomeadamente privação do sono ou sono prolongado, podem promover o início de crises de cefaleia, nomeadamente enxaqueca, 21 no entanto o sono pode ser o factor decisivo para a resolução de uma crise de cefaleia. História de abuso na infância tem sido mostrada como factor de risco para esta comorbilidade, assim como uso frequente de corticóides ou abuso de medicação.…”

Section: Mecanismos Subjacentes à Comorbilidadeunclassified

Comorbilidades Psiquiátricas Associadas às Cefaleias: a Experiência da Consulta de Ligação

2015

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Introduction:The comorbidity between headaches and psychiatric disorders is common and may be explained by different mechanisms in terms of uni or bi-directional models, or sharing of genetic and environmental risk factors relating to development of both clinical conditions. The presence of this comorbidity has important implications for patients with headaches and for patients with psychiatric disorders, worsens the clinical situation, increases the risk of chronicity, the pain intensity and the rate of treatment failure. Material and Methods:The authors performed a descriptive, retrospective study of prevalence, involving 250 patients seen in Psychiatry -Headaches liaison consultation, over a period of 3 years, from July 1, 2011 to July 1, 2013. The authors undertook the analysis of the clinical records, in respect to sociodemographic and clinical data, neurological and psychiatric diagnosis and prescribed therapy. Results and Discussion: During this period were made 689 liaison consultations, with a prevalence of female patients (84%) and a mean age of 47 years. The tension type headache (60.8%), migraine (24.8%) and headache attributed to psychiatric disorders (7.2%) were the most prevalent types of headaches. Mood disorders (62%) and neurotic stress related disorders (39.2%) were the most frequent psychiatric diagnoses. The therapeutic intervention in these cases emphasizes the multidisciplinary approach with the collaboration of Neurologist and Psychiatrist, based in psychoeducation, cognitive-behavioral intervention and psychopharmacological treatment. Conclusion:Given the complexity of the clinical picture in cases of comorbidity, the experience of psychiatry liaison consultation and multidisciplinary intervention has proved particularly valuable in treating these patients, configuring itself as the proper treatment of this comorbidity. Keywords: Comorbidity; Headache; Mental Disorders; Psychiatry. INTRODUÇÃOSegundo a Classificação Internacional de Cefaleias da Sociedade Internacional de Cefaleias (ICHD-3 beta),1 estas podem ser divididas em Cefaleias primárias, ou cefaleias secundárias quando ocorrem pela primeira vez em estreita relação temporal com outra alteração que é uma causa reconhecida de cefaleias.As cefaleias primárias compreendem a enxaqueca com ou sem aura, as cefaleias tipo tensão e a cefaleia em salvas, o tipo mais conhecido das cefaleias trigémino-autonómicas. As cefaleias secundárias podem ser devidas a situações de traumatismo crânio-encefálico e/ou cervical, doença vascular craniana ou cervical, perturbação intracraniana não vascular, uso de substâncias ou sua privação, infecção, perturbação da homeostase, perturbação de estruturas cranianas ou faciais e perturbações psiquiátricas. Por fim a parte 3 engloba as neuropatias cranianas dolorosas, outras dores faciais e outras cefaleias.As cefaleias primárias são geralmente conceptualizadas

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Section: Mecanismos Subjacentes à Comorbilidadeunclassified

Comorbilidades Psiquiátricas Associadas às Cefaleias: a Experiência da Consulta de Ligação

2015

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“…Relatively little research has been devoted to the group of child and adolescent patients with diseases of the nervous system, in whom there simultaneously appear signs of a spectrum of mental disorders that require treatment. The comorbidity of neurological and psychiatric disorders has been described, among others, in children with headaches [13,14], migraine [15], tic disorder [16], Tourette's syndrome [17], juvenile multiple sclerosis [18] and epilepsy [7,19]. The present work discusses the characteristics of patients from a diagnostic developmental neurology department, who manifested severe signs of mental problems and, as a result, were in need of a psychiatric consultation.…”

Section: Introductionmentioning

confidence: 92%

Symptoms of psychiatric diseases in a pediatric neurology department

Kaczmarek¹,

Kucharska²,

Cioczek³

et al. 2017

Arch Med Sci Civil Dis

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Introduction: The present study investigated the comorbidity of psychiatric symptoms among patients with neurological diseases and the possibility of the symptoms of mental disorders being masking by the symptoms of somatic disorders. Material and methods: Eight thousand two hundred and one epicrises of all patients hospitalized at the Department of Developmental Neurology from 1st January 2003 to 31st December 2013 were analyzed in order to select a group of patients referred for consultation with a child psychiatrist. The epicrises were analyzed in terms of diagnosis and the most common psychopathological symptoms on the basis of the State-Trait Anxiety Inventory, State-Trait Anxiety Inventory for Children, Eysenck Personality Questionnaire-Revised, Beck Depression Inventory, and the Schedule for Affective Disorders and Schizophrenia for School-Aged Children – Present and Lifetime (K-SADS-PL). Results: As a result of the analysis a group of 345 patients with serious symptoms requiring psychiatric consultation was selected. In the selected group, patients had the diagnosis of neurological as well as psychiatric diseases. The most frequently mentioned were: epilepsy (13.3%), emotional disorders (11.3%), tension-type headaches (11.3%) and conversion disorders (8.4%). Dominating psychopathological symptoms were: anxiety (64%), symptoms of mood disorders (31.6%) and signs of inattention (19.7%). Suicidal ideation was manifested by 21 (6.08%) persons. Conclusions: There is a need for careful observation of the mental state of each patient of a pediatric neurology department by an interdisciplinary team of doctors, psychologists and support staff.

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“…In one study, 29.6% of CDH patients met criteria for at least one current psychiatric diagnosis, and 34.9% met criteria for at least one-lifetime psychiatric diagnosis [53] . Depressive and anxiety disorders being the common disorders, other being dysthymia, phobic disorder, obsessive compulsive disorder, somatoform disorders, sleep difficulties and disorders (insufficient and poorer sleep quality, co-sleeping with parents, anxiety related to sleep, night waking, nightmares, bedwetting and pavor), suicidal ideation and an increased risk of suicidality [30,48,[50][51][52][54][55][56][57][58][59][60][61] .The lifetime prevalence of major depression was threefold higher in persons with migraine and in persons with a severe headache compared with controls [62] .TTH is associated with fewer close friends and had a higher rate of divorced parents [63] . Previous studies have shown a significant negative correlation between total intelligence quotient, verbal intelligence quotient, performance intelligence quotient and the frequency of headache attacks [64] .…”

Section: Co-morbiditiesmentioning

confidence: 99%

“…Previous studies have shown a significant negative correlation between total intelligence quotient, verbal intelligence quotient, performance intelligence quotient and the frequency of headache attacks [64] . Neurological disorders associated with a headache and migraine, are mainly epilepsy, ADHD and Tourette syndrome [52,55,61,65] .The prevalence of epilepsy in patients with migraine varies from 1 to 17%, with an average of 5.9%, and greatly exceeds that of the general population (0.5-1%) [61] . The risk of migraine is more than twice as high in subjects with epilepsy both in probands and in relatives, compared to people without epilepsy [66] .The most obvious association is between migraine with aura (MWA) and epilepsy, with a high prevalence of MWA (30.4%) than other types of primary headache in children with seizures [67] .…”

Section: Co-morbiditiesmentioning

confidence: 99%

“…Other medical problems associated with childhood headaches include atopic disorders (asthma, rhinitis or eczema), hay fever, frequent ear infections, anemia, hyperactive/impulsive behaviour, learning disabilities, stuttering, abdominal illnesses and bowel disease, enuresis, celiac disease, early menarche, and cardiovascular disease, especially ischemic stroke and patent foramen ovale (PFO) [1,61,[73][74][75][76][77][78] .…”

Section: Co-morbiditiesmentioning

confidence: 99%

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