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Yoon SY, Kim HM, Yi YY. The impact of the COVID-19 pandemic era on children with primary headache: a questionnaire survey study and literature review. Front Pediatr 2023; 11:1179979. [PMID: 37492607 PMCID: PMC10364439 DOI: 10.3389/fped.2023.1179979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023] Open
Abstract
Background The coronavirus disease (COVID-19) pandemic has resulted in individual isolation and secondary problems, especially in children. Research on the effect of the social isolation on children with primary headache is limited. This study aimed at exploring the effects of environmental changes caused by COVID-19 on headache in children. Methods This cross-sectional survey study enrolled school-aged children (age, 8-16 years) with headache who were able to complete the questionnaire from a Pediatric Headache Clinic between January 2021 and December 2022. Headache diaries for all patients were in their medical records and two questionnaire responses were requested at a 3-month interval. The questionnaires included headache type, frequency, previous medical conditions, family history, Pediatric Migraine Disability Assessment scores (PedMIDAS) scores, changes in daily life after COVID-19, and factors that aggravated headaches associated with social distancing. Results We identified 35 patients who were diagnosed with primary headache and continued to visit our outpatient clinic for at least 3 months. Among them, 33 (15 males and 18 females) patients responded to the first survey. The average age (±SD) of patients was 12.5 ± 1.9 years. PedMIDAS scores were not affected by the COVID-19 infection history. Prolonged use of masks and increased use of digital devices were reported as the most common factors that aggravated headache during the pandemic era. Conclusion COVID-19 did not affect in worsening primary headache in children. However, the pandemic can introduce various changes in daily life, which in turn can affect the management of headache. By gathering feedback regarding the thoughts of the patients on the impact of the current pandemic environment, patient counseling on the precautions and management can be conducted in advance in the case of repeated lockdown in the future.
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Affiliation(s)
- So Yeon Yoon
- Department of Pediatrics, Hallym University and Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Hye Min Kim
- Department of Pediatrics, Hallym University and Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
| | - Yoon Young Yi
- Department of Pediatrics, Hallym University and Kangdong Sacred Heart Hospital, Seoul, Republic of Korea
- Department of Pediatrics, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
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Lee KM, Koh MS, Lim HC, Ryu S, Kim YJ, Moon JH. Assessment of Parenting Attitudes by Children and Adolescents with Migraine. ANNALS OF CHILD NEUROLOGY 2022. [DOI: 10.26815/acn.2022.00164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Purpose: We aimed to investigate the parenting attitudes reported by patients and their relationships with the characteristics of headaches in children and adolescents with migraine. Methods: We conducted a retrospective review of medical records of children and adolescents with migrainous headaches (n=115; 59.1% female; mean age, 11.89±2.00 years). Children evaluated parental attitudes using the Parenting Attitude Test-Youth (PAT-Y), which comprises eight subscales and four newly devised secondary subscales. Headache severity was calculated by the visual analog scale (VAS), monthly frequency (MF), and VAS×MF/4 (VF). The scores of PAT-Y subscales and the correlations between PAT-Y scores and headache severity were analyzed by age group and sex. Scores for children’s depression inventory, childhood behavior checklists, and an attention deficit hyperactivity disorder scale were also analyzed. Results: In the elementary school age group, VAS was weakly negatively correlated with the “achievement press” (r=–0.28, P<0.05) and “high expectation” (r=–0.25, P<0.05) attitudes, and VF was weakly negatively correlated with “achievement press” (r=–0.32, P<0.05), “punishment” (r=–0.27, P<0.05), and “high expectation” (r=–0.29, P<0.05). In the middle-school age group, MF and VF were moderately positively correlated with the “achievement press” attitude (r=0.48, P<0.01 and r=0.48, P<0.01, respectively), VF was weakly positively correlated with the “neglectful” attitude(r=0.31, P<0.05), and MF was weakly positively correlated with scores for depression (r=0.29, P<0.05) and internalized problems (r=0.31, P<0.05). Conclusion: Parenting attitudes perceived by children and adolescents with migrainous headaches varied by age, and some parenting attitudes were related to headache severity. Education on age-appropriate parenting attitudes may help cope with migrainous headaches.
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Mingels S, Granitzer M. Cross-Sectional Study of Headache in Flemish Children and Adolescents. Child Neurol Open 2022; 9:2329048X221140783. [DOI: 10.1177/2329048x221140783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/11/2022] [Accepted: 11/03/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Although headache is common in pediatrics, data for the Flemish population are missing. We explored headache-prevalence, and its association with communication-technology (CT) and physical activity (PA) in Flemish children and adolescents. Methods: A cross-sectional exploratory school-based questionnaire study was designed. Flemish boys and girls (5–18 years) completed a symptom-questionnaire. Primary outcomes: sociodemographic background, headache-prevalence, headache-characteristics, CT-use and PA characteristics (self-report). Secondary outcomes: associations between headache-characteristics, age, gender, and CT-use and PA-characteristics. Results: Four hundred twenty-four questionnaires were analysed: 5–7-years: n = 58; 8–11-years: n = 84; 12–15-years: n = 137; 16–18-years: n = 145. Fifty-five percent suffered from headache. Prevalence increased with age. More 16–18-year girls versus boys had headache. CT-use was the main headache-provocateur. Headache prevalence was significantly higher in a frequently physical active population. Conclusion: Our results suggest presence of headache in Flemish children and adolescents. PA-level associates with headache prevalence. However, children and adolescents with headache did not report more CT-use compared to controls.
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Affiliation(s)
- Sarah Mingels
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium
| | - Marita Granitzer
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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The Psychiatric Comorbidities of Migraine in Children and Adolescents. Curr Pain Headache Rep 2021; 25:69. [PMID: 34766216 DOI: 10.1007/s11916-021-00983-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW Understanding comorbidities in migraine is important because it can help us understand disease pathophysiology while also aiding the development of more effective treatment strategies. Additionally, it can provide greater awareness about appropriate diagnosis, the need for additional disease screening, and the natural history of migraine. Psychiatric comorbidities have been independently studied in both adults and children with migraine because their presentations can be distinct, and the physiology in these two groups can be different. RECENT FINDINGS While symptoms of anxiety and depression seem to be comorbid with migraine in children, clinically significant disease does not appear to be, though the clarity of these data is limited by overlap between migraine symptomatology and that assessed by many screening tools. Functional neurologic disorders like psychogenic non-epileptic episodes (PNEE) and other functional movement disorders are not common but can be comorbid with migraine in this population and tend to improve with migraine treatment. The number of adverse childhood experiences (ACEs) a child is exposed to seems to be near-linearly associated with risk of migraine, but not with tension-type headache (TTH). The findings from these studies underscore the importance of utilizing appropriate screening methodologies for identifying psychiatric disorders in children with migraine. Additionally, the role of the insula, the hypothalamic-pituitary-adrenal axis, the serotonergic system, and the instability of hyperactivated neural networks may underlie the pathophysiology of both migraine and its psychiatric comorbidities.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to examine the multitude of factors which may impact learning and academic performance in patients with pediatric migraine. RECENT FINDINGS A range of associations of varying degree were noted between pediatric migraine and conditions such as ADHD, learning disabilities, sleep disorders, and psychiatric comorbidities with regard to headache pain and school functioning. Recent literature highlights the importance of sleep in relation to headache, mood disorders, and learning in youth and the emerging role of perfectionism. Children with migraine remain at risk for school related and learning difficulties which may be primarily due to pain, due to other medical and psychiatric comorbidities commonly found in this population, or a combination. The relationships are complex and further studies are needed to clearly elucidate the shared biological and environmental pathophysiologic mechanisms.
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Affiliation(s)
- Raquel Langdon
- The George Washington University School of Medicine & Health Sciences, Children's National Hospital, 111 Michigan Ave, NW, Washington, DC, 20010, USA.
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Do Children with Migraine-type Headache Exhibit Increased Levels of Anxiety? ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2020. [DOI: 10.21673/anadoluklin.613608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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El-Heneedy YAE, Bahnasy WS, ELAhwal SA, Amer RAR, Abohammar SDA, Salem HAM. Psychiatric and sleep abnormalities in school-age children with migraine. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2019. [DOI: 10.1186/s41983-019-0065-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Ertem DH, Bingol A, Ugurcan B, Mercan Ö, Simsek I, Sağlam H, Ozge A, Uluduz D. The impact of parental attitudes toward children with primary headaches. Clin Child Psychol Psychiatry 2019; 24:767-775. [PMID: 30895815 DOI: 10.1177/1359104519838571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
There is a lack of data on parental attitudes toward children with primary headaches. The aim of this study is to determine whether there is a relationship between primary headaches and parental attitudes in the pre-adolescent pediatric population. In this cross-sectional study, 195 children with primary headache and 43 healthy children aged 9-16 years were included. A questionnaire for sociodemographic variables, visual analog scale (VAS), Social Anxiety Scale and Depression Inventory for Adolescents and Children, and Parental Attitudes Determining Scale (PATS), which is an attitude measure specifically designed to evaluate psychological adjustment, were administered. Of 195 children (female/male ratio: 89/106, mean age: 12.59 ± 1.09 years), episodic migraine (n = 90), chronic migraine (n = 25), and tension-type headache (n = 80) were evaluated. There was no significant difference among headache groups and healthy subjects in terms of depression, anxiety, and fathers' attitude scale scores. However, there were significant differences in mean mothers' attitude scale scores and VAS scores (p = .002, p = .000). Mean oppressive-authoritarian attitude subscale scores of mothers' was significantly higher in children with chronic migraine (p = .000). A relationship between depression and VAS scores among all patient groups was detected (p = .000). Parental age was negatively related to PATS scores of children with episodic migraine and tension-type headache (p = .037 and p = .036). Parental attitudes may elevate psychiatric symptoms and influence children's perception of pain intensity and result in chronification of headache. Our findings support that mothers' attitude toward children with chronic migraine has strong impacts on the child's pain experience.
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Affiliation(s)
- Devrimsel Harika Ertem
- Department of Neurology, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Turkey
| | - Ayhan Bingol
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Turkey
| | - Busra Ugurcan
- Department of Guidance and Counseling, Bahçeşehir University, Turkey
| | - Özlem Mercan
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Turkey
| | - Ismail Simsek
- Department of Neurosurgery, Pendik Research and Training Hospital, Marmara University, Turkey
| | - Hanife Sağlam
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Turkey
| | - Aynur Ozge
- Department of Neurology, School of Medicine, Mersin University, Turkey
| | - Derya Uluduz
- Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Turkey
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Law EF, Palermo TM, Zhou C, Groenewald CB. Economic Impact of Headache and Psychiatric Comorbidities on Healthcare Expenditures Among Children in the United States: A Retrospective Cross-Sectional Study. Headache 2019; 59:1504-1515. [PMID: 31520418 DOI: 10.1111/head.13639] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine the annual healthcare expenditures associated with childhood headache in the United States, and to evaluate whether psychiatric comorbidities increase the impact of headache on expenditures. BACKGROUND Headache is prevalent in childhood and co-occurs with anxiety disorders, depressive disorders, and attention deficit/hyperactivity disorder (ADHD), which may increase cost of illness. METHODS We conducted a secondary data analysis using a nationally representative sample of 34,633 children ages 2-17 from the 2012-2015 Medical Expenditure Panel Surveys (MEPS), of which 779 (weighted 2.6%) were identified as having headache based on health service use associated with headache. Using a comprehensive cost-of-illness approach, we assessed the incremental expenditures associated with headache and determined excess expenditures associated with psychiatric comorbidities using standard adjusted 2-part expenditure models. RESULTS Annual total healthcare expenditures were estimated to be 24.3% higher, 95% CI [1,55], in our headache group ($3036, 95% CI [2374,3699] vs $2350, 95% CI [2140,2559]). Total national expenditures associated with pediatric headache in the United States were estimated at $1.1 billion annually, 95% CI [.04, 2.2 billion]. Depression and ADHD were associated with higher incremental expenditures for the headache group (depression: $1815, 95% CI[676,2953] vs $1409, 95% CI[697,2112]; ADHD: $4742, 95% CI[1659,7825] vs $2935, 95% CI[1977,3894]); however, interactions between psychiatric comorbidities and headache did not reach statistical significance. CONCLUSION Youth with headache exert a considerable economic burden on families, healthcare systems, and society. Due to the limitations in methods used to classify youth with headache in MEPS, our findings may underestimate the true prevalence and cost of pediatric headache in the United States. Further research with larger sample sizes is needed to understand the impact of psychiatric comorbidities on healthcare expenditures in this population.
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Affiliation(s)
- Emily F Law
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA.,Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA.,Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Chuan Zhou
- Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, USA.,Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Cornelius B Groenewald
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA.,Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, USA
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Law EF, Powers SW, Blume H, Palermo TM. Screening Family and Psychosocial Risk in Pediatric Migraine and Tension-Type Headache: Validation of the Psychosocial Assessment Tool (PAT). Headache 2019; 59:1516-1529. [PMID: 31318451 DOI: 10.1111/head.13599] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/05/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To present data on psychometric properties of the Psychosocial Assessment Tool 2.0_General (PAT), a brief screener for psychosocial risk in families of youth with medical conditions, in youth with headache. BACKGROUND Emotional and behavioral disturbances, parent distress, and poor family functioning are common among youth with recurrent migraine and tension-type headache; however, tools to comprehensively screen family and psychosocial risk in youth with headache are not currently available. The PAT could address an important gap by facilitating identification of psychosocial treatment needs among youth with headache. DESIGN AND METHODS Youth with recurrent migraine (with and without aura; chronic migraine) or tension-type headache (episodic and chronic) completed the PAT and validated measures of adolescent emotional and behavioral functioning, parent emotional functioning, and family functioning at baseline (n = 239; 157 from neurology clinic, 82 from the community) and 6-month follow-up (n = 221; 146 from neurology clinic, 75 from the community). RESULTS Internal consistency for the PAT Total score was strong (α = .88). At baseline, the PAT Total score was significantly associated in the expected direction with established measures of child emotional and behavioral functioning (r = .62), parent anxiety and depressive symptoms (r = .49; r = .53, respectively), and family functioning (r = .21). Predictive validity was demonstrated by a significant association between PAT Total scores at baseline with child emotional and behavioral functioning (r = .64), parent anxiety (r = .37), parent depression (r = .42), and family functioning (r = .26) at 6-month follow-up. CONCLUSIONS The PAT is a promising tool for screening psychosocial risk that could facilitate identification of psychosocial treatment needs among youth with recurrent headache at risk for poor outcomes.
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Affiliation(s)
- Emily F Law
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA.,Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Scott W Powers
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Heidi Blume
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA.,Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Tonya M Palermo
- Department of Anesthesiology & Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA.,Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, WA, USA
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Woods K, Ostrowski-Delahanty S, Cieplinski T, Winkelman J, Polk P, Victorio MC. Psychosocial and Demographic Characteristics of Children and Adolescents With Headache Presenting for Treatment in a Headache Infusion Center. Headache 2019; 59:858-868. [PMID: 31008518 DOI: 10.1111/head.13537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND Approximately 10% of pediatric patients have recurrent headaches, with migraine being the most common headache type. If untreated, migraine may progress to status migrainosus, a debilitating condition of prolonged duration, high pain severity, and significant disability. There is high variability in the treatment of status migrainosus including medications used and treatment setting, which may occur in the emergency room, as an inpatient admission, or, less often, in an outpatient infusion center. The paucity of research on the treatment of status migrainosus is a limitation to treatment effectiveness. OBJECTIVE The objective of the study was twofold. First, we sought to examine the demographic characteristics of children and adolescents accessing our outpatient infusion center for prolonged headache. Second, we sought to determine whether any demographic or psychosocial differences exist between patients who access infusion therapy compared to patients who do not access infusion therapy for their headaches. METHODS We conducted a retrospective chart review of all patients between the ages of 6 and 19 years who were treated in our outpatient headache infusion center. A subset of these patients completed a behavioral health evaluation (treatment group) and they were compared to a control group of similar age (birthdate within 6 months) and gender to patients not seeking infusion treatment. Variables of interest included patient demographics, headache type and characteristics, and scores on the Pediatric Quality of Life Inventory (PedsQL), Functional Disability Inventory (FDI), Pediatric Pain Coping Inventory (PPCI), and the Behavior Assessment System for Children - Second Edition (BASC-2). RESULTS A total of 284 patients were included in the study (n = 227 receiving infusion treatment and n = 57 controls). Patients were primarily female (224/286; 78.9%), Caucasian (254/286; 90.1%), and had a mean age of 15 years. Findings suggest a promising difference in the PPCI Distraction subscale, χ2 (1) = 3.7, P = .054, with a mean rank score of 61.90 for the treatment group and 50.21 for the control group. Additionally, a statistically significant difference was noted on the Social Support subscale, χ2 (1) = 10.6, P = .001, with a mean rank score of 65.92 for the treatment group and 46.26 for the control group. Results also indicated a statistically significant difference in disability scores, χ2 (1) = 10.0, P = .002, with a mean rank FDI score of 66.83 for the treatment group and 47.34 for the control group. Patients in the infusion group also reported lower quality of life on the PedsQL Total score (F[1, 109] = 5.0, P = .028; partial η2 = 0.044), and on the Physical (F[1, 109] = 7.9, P = .006; partial η2 = 0.069) and School (F[1, 109] = 4.6, P = .035; partial η2 = 0.041) subscales. No significant differences were found on the BASC-2. Parent reported data also revealed a significantly higher level of disability among patients seeking infusion treatment compared to the non-infusion group χ2 (1) = 11.7, P = .001. However, there were no significant differences on the PedsQL, PPCI, or BASC-2. CONCLUSIONS Our findings support the disabling nature of migraine among children and adolescents, with higher levels of disability and lower quality of life reported in the group of patients utilizing infusion treatment. Developing concrete treatment plans and goals combined with bio-behavioral therapy are necessary to reduce functional disability and increase quality of life among these patients. Awareness of this patient group's pain-related coping strategies may help health care providers tailor treatment recommendations and develop or refine cognitive-behavioral headache treatment techniques.
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Affiliation(s)
- Kristine Woods
- NeuroDevelopmental Science Center, Akron Children's Hospital, Akron, OH, USA
| | | | - Tami Cieplinski
- NeuroDevelopmental Science Center, Akron Children's Hospital, Akron, OH, USA
| | - Jonathan Winkelman
- NeuroDevelopmental Science Center, Akron Children's Hospital, Akron, OH, USA
| | - Pretti Polk
- NeuroDevelopmental Science Center, Akron Children's Hospital, Akron, OH, USA
| | - M Cristina Victorio
- NeuroDevelopmental Science Center, Akron Children's Hospital, Akron, OH, USA
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Andrasik F, Grazzi L, Sansone E, D'Amico D, Raggi A, Grignani E. Non-pharmacological Approaches for Headaches in Young Age: An Updated Review. Front Neurol 2018; 9:1009. [PMID: 30538669 PMCID: PMC6277635 DOI: 10.3389/fneur.2018.01009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/08/2018] [Indexed: 12/12/2022] Open
Abstract
Headache disorders are common in children and adolescents. Most of the studies on non-pharmacological treatments have however been carried out on adults. In this review we provide information on recent studies examining non-pharmacological approaches for managing headache in children and adolescents. Our search of SCOPUS for primary studies conducted between January 2010 and July 2018 uncovered 11 controlled studies, mostly addressing behavioral approaches, in which a total of 613 patients with a diagnosis of primary headache, and average age 10.2–15.7 years (30–89% females) were recruited. Non-pharmacological treatments were shown to produce sizeable effects on the classical primary endpoint, i.e., headache frequency, with reductions from baseline ranging between 34 and 78%. Among commonly reported secondary endpoints, particularly disability, quality of life, depression and anxiety, marked improvements were noted as well. Taken as a whole, our findings suggest that non-pharmacological treatments constitute a valid option for the prevention of primary headaches in young age. Future research with higher-quality studies is needed. Particular attention needs to be given to studies that randomize patients to condition, blind researchers in charge of evaluating treatment outcomes, routinely include headache frequency as the primary endpoint, include adequate-length follow-up, address changes in biomarkers of disease and other possible mediators of outcome, and that employ predictive models to enhance the level of evidence for these approaches.
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Affiliation(s)
- Frank Andrasik
- Department of Psychology, University of Memphis, Memphis, TN, United States
| | - Licia Grazzi
- Neuroalgology Division, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Emanuela Sansone
- Neuroalgology Division, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Domenico D'Amico
- Neuroalgology Division, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Neurology, Milan, Italy
| | - Eleonora Grignani
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Neurology, Milan, Italy
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Benore E, Webster EE, Wang L, Banez G. Longitudinal Analysis of Patient-Reported Outcomes From an Interdisciplinary Pediatric Pain Rehabilitation Program for Children With Chronic Migraine and Headache. Headache 2018; 58:1556-1567. [DOI: 10.1111/head.13389] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2018] [Indexed: 01/23/2023]
Affiliation(s)
- Ethan Benore
- Cleveland Clinic - Pediatric Behavioral Health; Cleveland OH USA
| | - Erin E. Webster
- Cleveland Clinic - Pediatric Behavioral Health; Cleveland OH USA
| | - Lu Wang
- Cleveland Clinic Children's Hospital - Quantitative Health Sciences; Cleveland OH USA
| | - Gerard Banez
- Cleveland Clinic - Pediatric Behavioral Health; Cleveland OH USA
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