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Orr SL. Parental mental health and migraine in youth: An evolving story historically plagued with sparse and inadequate literature and mother-blaming. Headache 2024. [PMID: 38934206 DOI: 10.1111/head.14779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Serena L Orr
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Section of Neurology, Alberta Children's Hospital, Calgary, Alberta, Canada
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Beveridge JK, Noel M, Soltani S, Neville A, Orr SL, Madigan S, Birnie KA. The association between parent mental health and pediatric chronic pain: a systematic review and meta-analysis. Pain 2024; 165:997-1012. [PMID: 38112571 DOI: 10.1097/j.pain.0000000000003125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/10/2023] [Indexed: 12/21/2023]
Abstract
ABSTRACT Mental health problems are common among parents of children with chronic pain and associated with worse outcomes for the child with chronic pain. However, the effect sizes of these associations between parent mental health and pediatric chronic pain vary widely across studies. The aim of this systematic review and meta-analysis was to generate pooled estimates of the (1) prevalence of mental health problems among parents of children with chronic pain and (2) associations between parent mental health and the (2a) presence of child chronic pain and (2b) functioning of children with chronic pain. Embase, MEDLINE, PsycINFO, Web of Science, and CINAHL were searched up to November 2022. Observational studies that examined symptoms or diagnoses of parent anxiety, depression, or general distress and the presence of child chronic pain and/or related functioning were included. From 32,848 records, 2 coders identified 49 studies to include in random-effects meta-analyses. The results revealed that mental health problems among parents of children with chronic pain were common (anxiety: 28.8% [95% CI 20.3-39.1]; depression: 20.0% [15.7-25.2]; general distress: 32.4% [22.7-44.0]). Poorer parent mental health was significantly associated with the presence of chronic pain (anxiety: OR = 1.91 [1.51-2.41]; depression: OR = 1.90 [1.51-2.38]; general distress: OR = 1.74 [1.47-2.05]) and worse related functioning (ie, pain intensity, physical functioning, anxiety and depression symptoms; r s = 0.10-0.25, all P s < 0.05) in children. Moderator analyses were generally nonsignificant or could not be conducted because of insufficient data. Findings support the importance of addressing parent mental health in the prevention and treatment of pediatric chronic pain.
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Affiliation(s)
- Jaimie K Beveridge
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Sabine Soltani
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Alexandra Neville
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Serena L Orr
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Departments of Community Health Sciences
- Pediatrics and Clinical Neurosciences, and
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Kathryn A Birnie
- Department of Psychology, University of Calgary, Calgary, AB, Canada. Neville is now with the Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Departments of Community Health Sciences
- Anesthesiology, Perioperative, and Pain Medicine, University of Calgary, Calgary, AB, Canada
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Orr SL. Headache in Children and Adolescents. Continuum (Minneap Minn) 2024; 30:438-472. [PMID: 38568493 DOI: 10.1212/con.0000000000001414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This article reviews the assessment of children and adolescents presenting with headache, provides an overview of primary headache disorders, and reviews evidence-based management of headache in this age group. LATEST DEVELOPMENTS In the last few years, new epidemiological data have shed light on less common pediatric headache disorders (eg, pediatric trigeminal autonomic cephalalgias) and psychosocial risk factors associated with primary headache disorders in children and adolescents. There has also recently been a substantial increase in interventions that target the calcitonin gene-related peptide pathway and that treat primary headache disorders using noninvasive neuromodulation. Although these interventions have primarily been studied in adults, there is emerging evidence of their use in the pediatric population. ESSENTIAL POINTS Primary headache disorders are very common in youth, and the most commonly encountered headache diagnosis in neurology practice is migraine, which affects approximately 10% of children and adolescents. Diagnosing and effectively treating primary headache disorders before adulthood may have a sustained impact on the patient by improving long-term headache and mental health outcomes, thereby significantly reducing the burden of disability over time. There are several available and emerging acute and preventive interventions for youth with primary headache disorders, and treatment decisions should be made in the context of available evidence using a shared decision-making approach.
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Nilles C, Williams JV, Patten SB, Pringsheim TM, Orr SL. Lifestyle Factors Associated With Frequent Recurrent Headaches in Children and Adolescents: A Canadian Population-Based Study. Neurology 2024; 102:e209160. [PMID: 38417103 DOI: 10.1212/wnl.0000000000209160] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/07/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Lifestyle behaviors have been postulated to affect headache frequency in youth and are often the primary target of self-management recommendations. Our study aimed to assess the association between various lifestyle factors and frequent recurrent headaches in children and youth. METHODS Children and adolescents aged 5-17 years were enrolled in a large cross-sectional Canadian population-based health survey, completed on January 31, 2019. Headache frequency was dichotomized into "approximately once/week or less" or ">once/week" (defined as frequent recurrent headaches). The association between frequent headaches and meal schedules, screen exposure, physical activity, chronotype, and frequent substance use/exposure (alcohol, cigarettes, electronic cigarettes, and cannabis) was assessed using both unadjusted logistic regression models and models adjusted for age/sex. Fully adjusted models examined the odds of frequent headaches according to all exposures. Survey design effects were accounted for using bootstrap replicate weighting. RESULTS There were an estimated nweighted = 4,978,370 eligible participants in the population. The mean age was 10.9 years (95% CI 10.9-11.0); 48.8% were female; 6.1% had frequent headaches. Frequent headaches were associated with older age (odds ratio [OR] = 1.31, 95% CI 1.28-1.34, p < 0.001) and female sex (OR = 2.39, 95% CI 2.08-2.75, p < 0.001). In models adjusted for age/sex, the odds of frequent headaches decreased with meal regularity (adjusted OR [aOR] = 0.90, 95% CI 0.89-0.92, p < 0.001) and increased with later chronotype (aOR = 1.10, 95% CI 1.05-1.15, p < 0.001) and excess screen exposure (≥21 hours vs none in past week: aOR = 2.97, 95% CI 1.53-5.77, p = 0.001); there was no significant association with reported physical activity (aOR = 0.95, 95% CI 0.67-1.34, p = 0.77). In 12- to 17-year-olds, frequent headaches were associated with frequent alcohol use (≥1/wk vs never: aOR = 3.50, 95% CI 2.18-5.62, p < 0.001), binge drinking (≥5 times in past month vs never: aOR = 5.52, 95% CI 2.95-10.32, p < 0.001), smoking cigarettes (daily vs never: aOR = 3.81, 95% CI 1.91-7.62, p < 0.001), using e-cigarettes (daily vs never: aOR = 3.10, 95% CI 2.29-4.20, p < 0.001), and cannabis use (daily vs never: aOR = 3.59, 95% CI 2.0-6.45, p < 0.001). In the entire sample, daily exposure to smoking inside the house was associated with frequent headaches (aOR = 2.00, 95% CI 1.23-3.27, p = 0.005). DISCUSSION Several lifestyle behaviors were associated with frequent headaches in children and youth, such as meal irregularity, late chronotype, prolonged screen exposure, and frequent substance use/exposure, suggesting that these are potential modifiable risk factors to target in this population.
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Affiliation(s)
- Christelle Nilles
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Jeanne V Williams
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Scott B Patten
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Tamara M Pringsheim
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Serena L Orr
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
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Nilles C, Williams JVA, Patten S, Pringsheim T, Orr SL. Association Between Peer Victimization, Gender Diversity, Mental Health, and Recurrent Headaches in Adolescents: A Canadian Population-Based Study. Neurology 2023; 101:e1654-e1664. [PMID: 37532511 PMCID: PMC10624480 DOI: 10.1212/wnl.0000000000207738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/20/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES It is unknown whether bullying and gender diversity are associated with increased headache frequency in adolescents. Our study aimed to assess the association between peer victimization, gender diversity, and frequent recurrent headaches in adolescents, while controlling for age, sex, socioeconomic status, and potential confounders (mood and anxiety disorders, suicidality). METHODS This was a cross-sectional observational study of adolescents aged 12-17 years using data from a Canadian population-based health survey. Headache frequency was dichotomized into "≤once/wk" or ">once/wk" (i.e., frequent recurrent headaches). Logistic regression was used to quantify the association between frequent peer victimization (overt or relational), gender diversity (female sex at birth + male gender, male sex at birth + female gender, or gender diverse), mood/anxiety disorder, suicidality, and the odds of frequent recurrent headaches. The fully adjusted multivariable logistic regression model included all exposures and was controlled for age, sex, and socioeconomic status. Bootstrap replicate weighting was used to account for survey design effects. RESULTS There were an estimated 2,268,840 eligible participants (weighted sample size) (mean age = 14.4 years, 48.8% female, 0.5% gender diverse), and 11.2% reported frequent recurrent headaches. Frequent recurrent headaches were associated with older age (odds ratio [OR] = 1.26 per year of age, 95% CI 1.20-1.31), female sex (OR = 2.89, 95% CI 2.47-3.37), and being gender diverse (OR = 3.30, 95% CI 1.64-6.63, adjusted for age/sex). Youth with frequent headaches had higher odds of experiencing both overt and relational bullying compared with peers (OR = 2.69, 95% CI 2.31-3.14, and OR = 3.03, 95% CI 2.58-3.54, adjusted for age/sex). In the fully adjusted model, frequent headaches were no longer associated with gender diversity (OR = 1.53, 95% CI 0.63-3.69) but were still associated with frequent overt and relational peer victimization (OR = 1.82, 95% CI 1.41-2.34, and OR = 1.54, 95% CI 1.17-2.03, respectively), suicidality (OR = 1.83, 95% CI 1.44-2.32), and having a mood or anxiety disorder (OR = 1.50, 95% CI 1.01-2.21, and OR = 1.74, 95% CI 1.24-2.45, respectively). In a model adjusted for age, sex, and mood/anxiety disorders, the risk of suicidality increased incrementally with headache frequency. DISCUSSION Peer victimization and suicidality may be associated with higher headache frequency in adolescents with headaches, independently of mood and anxiety symptoms. Gender-diverse adolescents may have a higher risk of experiencing frequent headaches when compared with cisgender peers, and this may be explained by associated psychosocial factors (anxiety, depression, suicidality, and peer victimization).
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Affiliation(s)
- Christelle Nilles
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Jeanne V A Williams
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Scott Patten
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Tamara Pringsheim
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Serena L Orr
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada.
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Kobus M, Sitek A, Antoszewski B, Rożniecki JJ, Pełka J, Żądzińska E. The impact of exposure to tobacco smoking and maternal trauma in fetal life on risk of migraine. Front Neurosci 2023; 17:1191091. [PMID: 37456999 PMCID: PMC10338879 DOI: 10.3389/fnins.2023.1191091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/29/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Prenatal period is the key time in human development. Many prenatal factors are well-known and increase the risk of developing diseases' after birth. Few studies indicated the link between the prenatal period and the prevalence of migraine in childhood and adolescence so far. We decided to broaden current knowledge and investigate whether the prenatal factors influence the prevalence of migraine in adulthood. The objective of this study is to provide evidence of relationship between in utero environment and risk of migraine. Methods In total 266 females (136 in the migraine group, 130 in the control group) and 80 males (35 in the migraine group, 45 in the control group), aged 18-65 participated in the study. The quality of prenatal environment was characterized on the basis of mother's and father's education, tobacco smoke exposure, alcohol consumption, and traumatic event during pregnancy, which are considered as prenatal factors and affect on fetal development. Results Migraine occurrence in adulthood was significantly associated with maternal tobacco smoking during pregnancy (OR 3.42, 95% CI 1.54-7.61, p = 0.036) and traumatic event during pregnancy (OR 2.27, 95% CI 1.24-4.13, p = 0.020). Discussion Our study suggests that the fetal programming effect of tobacco smoking exposure and maternal trauma is not limited to prenatal life and is suggested as having a role in adulthood. Our findings support evidence that migraine adulthood can be partly influenced by early life conditions.
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Affiliation(s)
- Magdalena Kobus
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, Łódź, Poland
| | - Aneta Sitek
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, Łódź, Poland
| | - Bogusław Antoszewski
- Department of Plastic, Reconstructive and Esthetic Surgery, Institute of Surgery, Medical University of Lodz, Łódź, Poland
| | - Jacek J. Rożniecki
- Department of Neurology, Stroke and Neurorehabilitation, Medical University of Lodz, Lodz, Poland
| | - Jacek Pełka
- Department of Neurology, Norbert Barlicki Memory University Teaching Hospital, Lodz, Poland
| | - Elżbieta Żądzińska
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, Łódź, Poland
- Biological Anthropology and Comparative Anatomy Research Unit, School of Medicine, The University of Adelaide, Adelaide, SA, Australia
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Martin VT, Fassler CS, Brunst KJ, Ying J, Teitelbaum S, Windham GC, Deardorff J, Wolff MS, Kushi LH, Biro FM, Pinney SM. Migraine and its association with pubertal maturation and behavioral traits among adolescent girls. Acta Neurol Belg 2023:10.1007/s13760-022-02161-2. [PMID: 36631631 DOI: 10.1007/s13760-022-02161-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 12/01/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To determine if the ages at pubertal milestones are associated with the prevalence of adolescent migraine. BACKGROUND Migraine headaches are a common disease in adolescent girls. Past studies have evaluated the relationship between age of onset of menarche and migraine headache, but none have studied earlier pubertal milestones such as thelarche and pubarche. METHODS In this cross-sectional study, a previously validated questionnaire was administered to girls (15-18 years) in Breast Cancer and the Environment Research Program puberty cohort to ascertain if they met criteria for migraine over the past year. Ages of pubertal development were ascertained by serial examinations beginning at 6-8 years of age and ending in late puberty. Logistic regression analyses determined if age of onset of each pubertal milestone (thelarche, pubarche, menarche separately) was associated with adolescent migraine after adjusting for other risk factors. RESULTS Of 761girls, 222 (29.2%) met the criteria for migraine. Later thelarche was associated with a lower odds of adolescent migraine (OR 0.83; 95% CI 0.72-0.97, p = 0.019). In models further adjusted for BASC-2 internalizing problems (n = 490), both later thelarche (OR 0.78; 95% CI 0.64-0.96, p = 0.016) and later menarche (OR 0.81; 95%CI 0.67-0.98, p = 0.026) were associated with a lower migraine prevalence. Internalizing problems (OR 1.05; 95% CI 1.03-1.07) externalizing problems (OR 1.05; 95% CI 1.02-1.07) and behavioral symptoms (OR 1.05; 95% CI 1.03-1.08) were associated with increased prevalence of migraine in separate models. CONCLUSIONS Age of onset of thelarche and menarche, and internalizing, externalizing, and behavioral symptoms were all associated with adolescent migraine.
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Affiliation(s)
- Vincent T Martin
- Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Cecily S Fassler
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kelly J Brunst
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jun Ying
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Susan Teitelbaum
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Julianna Deardorff
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Mary S Wolff
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Frank M Biro
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Susan M Pinney
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA. .,Kettering Lab Building, Room 208, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA.
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Sanders AE, Weatherspoon ED, Ehrmann BM, Soma PS, Shaikh SR, Preisser JS, Ohrbach R, Fillingim RB, Slade GD. Ratio of Omega-6/Omega-3 Polyunsaturated Fatty Acids Associated With Somatic and Depressive Symptoms in People With Painful Temporomandibular Disorder and Irritable Bowel Syndrome. THE JOURNAL OF PAIN 2022; 23:1737-1748. [PMID: 35477107 PMCID: PMC9561958 DOI: 10.1016/j.jpain.2022.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/24/2022] [Accepted: 04/07/2022] [Indexed: 04/27/2023]
Abstract
Somatic symptom disturbance is among the strongest predictors of painful temporomandibular disorder (TMD). Related psychological constructs, such as anxiety and depression, respond therapeutically to omega-3 polyunsaturated fatty acids (PUFAs) in clinical trials. This cross-sectional study investigated associations between the omega-6/omega-3 PUFA ratio and somatic symptom disturbance and depressive symptoms in a community-based sample of 501 adults and determined whether these associations differed between adults with and without TMD or irritable bowel syndrome (IBS). Liquid chromatography tandem mass spectrometry quantified PUFAs in circulating erythrocytes. Somatic symptoms and depression were quantified using Symptom Checklist-90-Revised subscales. Presence or absence of TMD and IBS, respectively, were determined by clinical examination and Rome III screening questions. The standardized beta coefficient for the omega-6/omega-3 long-chain PUFA ratio was 0.26 (95% confidence limits (CL): 0.08, 0.43) in a multivariable linear regression model in which somatic symptom disturbance was the dependent variable. When modelling depressive symptoms as the dependent variable, the standardized beta coefficient was 0.17 (95% CL:0.01, 0.34). Both associations were stronger among TMD cases and IBS cases than among non-cases. Future randomized control trials that lower the omega-6/omega-3 PUFA ratio could consider somatic or depressive symptoms as a therapeutic target for TMD or IBS pain. PERSPECTIVE: In people with TMD or IBS, a high n-6/n-3 PUFA ratio was positively associated with somatic symptom disturbance and depressive symptoms. Both measures of psychological distress were elevated in people with painful TMD and IBS. Future randomized clinical trials will determine whether lowering the n-6/n-3 ratio is therapeutic for pain.
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Affiliation(s)
- Anne E Sanders
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina.
| | - E Diane Weatherspoon
- Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina
| | - Brandie M Ehrmann
- Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina
| | - Paul S Soma
- Department of Chemistry, University of North Carolina, Chapel Hill, North Carolina
| | - Saame R Shaikh
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - John S Preisser
- Department of Biostatistics, University of North Carolina, Chapel Hill, North Carolina
| | - Richard Ohrbach
- Department of Oral Diagnostic Sciences, University at Buffalo, Buffalo, New York
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida; Pain Research and Intervention Center of Excellence, Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida
| | - Gary D Slade
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
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Amendola S, Hengartner MP, Spensieri V, Grillo L, Cerutti R. Patterns of internalizing symptoms and disability functioning in children and adolescents. Eur Child Adolesc Psychiatry 2022; 31:1455-1464. [PMID: 33909142 DOI: 10.1007/s00787-021-01789-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 04/15/2021] [Indexed: 12/19/2022]
Abstract
Despite findings from previous studies, there is still little consistent knowledge regarding the co-occurrence patterns of somatic, depressive and anxiety symptoms in childhood and adolescence. Moreover, functional disability due to somatic symptoms at different concomitant levels of depression and anxiety is understudied. The present study examined the co-occurrence patterns of somatic symptoms and symptoms of depression and anxiety, in children and adolescents using two-step cluster analysis. Differences in functional disability due to somatic symptoms were tested with ANCOVA controlling for gender and age. The sample comprised 1127 Italian children and adolescents (48.7% males, n = 549) aged 8-16 years (Mage = 11.7, SD = 2.37). Data were collected using the Children Somatization Inventory-24, the Children Depression Inventory, the Screen for Child Anxiety Related Emotional Disorders, and the Functional Disability Inventory. A four-cluster solution based on the co-occurrence of internalizing symptoms best fit the data. The four clusters were labelled as follows: cluster 1: "High somatic symptoms and average depression/anxiety"; cluster 2: "High somatic symptoms and high depression/anxiety"; cluster 3: "Average somatic symptoms and above average depression/anxiety"; and cluster 4: "Low somatic symptoms and low depression/anxiety". Significant differences between the four groups according to gender and age were shown. Participants with high levels of somatic, depressive, and anxiety symptoms reported greater functional disability due to somatic symptoms than the other three groups. Our findings indicate that children and adolescents who demonstrate high symptoms of depression and anxiety also reported higher levels of disability in daily life due to somatic symptoms.
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Affiliation(s)
- Simone Amendola
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via degli Apuli 1, 00185, Rome, Italy
| | - Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Pfingstweidstrasse 96, Zurich, 8005, Switzerland
| | - Valentina Spensieri
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via degli Apuli 1, 00185, Rome, Italy
| | - Luciano Grillo
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via degli Apuli 1, 00185, Rome, Italy
| | - Rita Cerutti
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Via degli Apuli 1, 00185, Rome, Italy.
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10
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Tietjen GE. The relationship of childhood adversity and migraine and the value of prospective studies. Headache 2022; 62:223-224. [DOI: 10.1111/head.14268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 11/30/2022]
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11
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Hammond NG, Colman I, Orr S. Adverse childhood experiences and onset of migraine in Canadian adolescents: A cohort study. Headache 2022; 62:319-328. [DOI: 10.1111/head.14256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Nicole G. Hammond
- School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada
| | - Ian Colman
- School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada
- Centre for Fertility and Health Norwegian Institute of Public Health Oslo Norway
| | - Serena L. Orr
- Departments of Pediatrics, Community Health Sciences, and Clinical Neurosciences Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Pediatric Headache Program Section of Pediatric Neurology Alberta Children's Hospital Calgary Alberta Canada
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12
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Lee RY, Oxford ML, Sonney J, Enquobahrie DA, Cato KD. The mediating role of anxiety/depression symptoms between adverse childhood experiences (ACEs) and somatic symptoms in adolescents. J Adolesc 2022; 94:133-147. [PMID: 35353421 PMCID: PMC9511877 DOI: 10.1002/jad.12012] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/12/2022] [Indexed: 11/09/2022]
Abstract
INTRODUCTION This study examines the relationships among recent adverse childhood experiences (ACEs), somatic symptoms, and anxiety/depression symptoms during adolescence and whether anxiety/depression symptoms mediate the relationship between ACEs and somatic symptoms. METHODS Longitudinal prospective data from the Longitudinal Studies of Child Abuse and Neglect study of 1354 children and their primary caregivers in the United States was used in this study. A longitudinal cross-lagged path analysis among recent ACEs, anxiety/depression symptoms, and somatic symptoms at three points during adolescence (ages 12, 14, and 16 years) was conducted. RESULTS The sample was 51% female and 53% African American. The results indicated significant concurrent associations between recent ACEs and increased anxiety/depression symptoms at ages 12, 14, and 16 (β = .27, p < .001; β = .15, p < .001; β = .07, p < .05) and between anxiety/depression symptoms and increased somatic symptoms at ages 12, 14, and 16 years (β = .44, p < .001; β = .39, p < .001; β = .49, p < .001). Moreover, anxiety/depression symptoms significantly mediated the relationship between recent ACEs and concurrent somatic symptoms at ages 12, 14, and 16 years (β = .12, p < .001; β = .06, p < .001; β = .04, p < .05). However, there was no significant relationship between recent ACEs and somatic symptoms. CONCLUSION The findings suggest that anxiety/depression symptoms mediate the concurrent relationships between recent ACEs and somatic symptoms at ages 12, 14, and 16. Clinicians should consider assessing anxiety/depression symptoms and possible concurrent exposure to ACEs when caring for adolescents who present with somatic symptoms.
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Affiliation(s)
- Rachel Y. Lee
- School of Nursing, Columbia University, New York City, New York, USA
| | - Monica L. Oxford
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | - Jennifer Sonney
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | | | - Kenrick D. Cato
- School of Nursing, Columbia University, New York City, New York, USA
- Department of Emergency Medicine, Columbia University College of Physicians & Surgeons, New York City, New York, USA
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13
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Stubberud A, Buse DC, Kristoffersen ES, Linde M, Tronvik E. Is there a causal relationship between stress and migraine? Current evidence and implications for management. J Headache Pain 2021; 22:155. [PMID: 34930118 PMCID: PMC8685490 DOI: 10.1186/s10194-021-01369-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 12/01/2021] [Indexed: 12/13/2022] Open
Abstract
Background The purpose of this narrative review is to examine the literature investigating a causal relationship between stress and migraine and evaluate its implications for managing migraine. Methods PubMed, PsycINFO and CINAHL were searched from 1988 to August 2021, identifying 2223 records evaluating the relationship between stress and migraine. Records were systematically screened. All potentially relevant records were thematically categorized into six mechanistic groups. Within each group the most recent reports providing new insights were cited. Results First, studies have demonstrated an association of uncertain causality between high stress loads from stressful life events, daily hassles or other sources, and the incidence of new-onset migraine. Second, major stressful life events seem to precede the transformation from episodic to chronic migraine. Third, there is some evidence for changes in levels of stress as a risk factor for migraine attacks. Research also suggests there may be a reversed causality or that stress-trigger patterns are too individually heterogeneous for any generalized causality. Fourth, migraine symptom burden seems to increase in a setting of stress, partially driven by psychiatric comorbidity. Fifth, stress may induce sensitization and altered cortical excitability, partially explaining attack triggering, development of chronic migraine, and increased symptom burden including interictal symptom burden such as allodynia, photophobia or anxiety. Finally, behavioral interventions and forecasting models including stress variables seem to be useful in managing migraine. Conclusion The exact causal relationships in which stress causes incidence, chronification, migraine attacks, or increased burden of migraine remains unclear. Several individuals benefit from stress-oriented therapies, and such therapies should be offered as an adjuvant to conventional treatment and to those with a preference. Further understanding the relationship between stress, migraine and effective therapeutic options is likely to be improved by characterizing individual patterns of stress and migraine, and may in turn improve therapeutics.
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Affiliation(s)
- Anker Stubberud
- Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway. .,National Advisory Unit on Headaches, Department of Neurology, St. Olavs Hospital, Trondheim, Norway.
| | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Espen Saxhaug Kristoffersen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway.,Department of General Practice, University of Oslo, Oslo, Norway
| | - Mattias Linde
- Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology, St. Olavs Hospital, Trondheim, Norway
| | - Erling Tronvik
- Department of Neuromedicine and Movement Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology, St. Olavs Hospital, Trondheim, Norway
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14
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The Role of Single Nucleotide Variants of NOS1, NOS2, and NOS3 Genes in the Development of the Phenotype of Migraine and Arterial Hypertension. Brain Sci 2021; 11:brainsci11060753. [PMID: 34200123 PMCID: PMC8228947 DOI: 10.3390/brainsci11060753] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 05/30/2021] [Accepted: 06/03/2021] [Indexed: 12/12/2022] Open
Abstract
Migraine (M) and arterial hypertension (AH) are very common diseases. Today, there are a number of studies confirming and explaining their comorbidity. We searched PubMed, Springer, Scopus, Web of Science, Clinicalkeys, and Google Scholar databases for full-text English publications over the past 15 years using keywords and their combinations. The present review provides a synthesis of information about single nucleotide variants (SNVs) of NOS1, NOS2, and NOS3 genes involved in the development of M and essential AH. The results of studies we have discussed in this review are contradictory, which might be due to different designs of the studies, small sample sizes in some of them, as well as different social and geographical environments. Despite a high prevalence of the M and AH phenotype, its genetic markers have not yet been sufficiently studied. Specifically, there are separate molecular genetic studies aimed to identify SNVs of NOS1, NOS2, and NOS3 genes responsible for the development of M and those responsible for the development of AH. However, these SNVs have not been studied in patients with the phenotype of M and AH. In this review, we identify the SNVs that would be the most interesting to study in this aspect. Understanding the role of environmental factors and genetic predictors will contribute to a better diagnostics and exploration of new approaches to pathogenetic and disease-modifying treatment of the M and AH phenotype.
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15
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Baiden P, Tarbet Z, Chakravarty S, LaBrenz CA, Okumu M. Functional difficulties mediate the association between exposure to adverse childhood experiences and headaches among children: Findings from a population-based study. Headache 2021; 61:673-682. [PMID: 33891349 DOI: 10.1111/head.14098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/15/2021] [Accepted: 02/08/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are commonly observed in the general population and often have lasting neurological and physiological effects. Previous studies have found links between exposure to ACEs, headaches, and functional difficulties in adults. However, little is known about the mechanisms through which exposure to ACEs is associated with headaches among children. OBJECTIVE To examine the association between exposure to ACEs and headaches in children, and whether functional difficulties mediate this association. METHODS Data for this cross-sectional secondary analysis study came from the 2017-2018 National Survey of Children's Health. The sample analyzed in this study was 40,953 children who were between ages 3 and 17 years. We adjusted for the complexity of the sampling design and used structural equation modeling to examine the mediating effect of functional difficulties in the association between exposure to ACEs and headaches. RESULTS Based on parent reports, we found that 4.1% (1697/40,953) of the children reported frequent or severe headaches, and 9.5% (3906/40,953) were exposed to three or more ACEs. About one in four children (23.4%; 9601/40,953) had at least one functional difficulty. The results show that exposure to ACEs was directly positively associated with functional difficulties (β = 0.16, p < 0.001, 95% CI = 0.15-0.17), and functional difficulties were in turn positively associated with headaches (β = 0.17, p < 0.001, 95% CI = 0.12-0.22). The Sobel test of indirect effect showed that functional difficulties partially mediated the association between exposure to ACEs and headaches (β = 0.027, p < 0.001, 95% CI = 0.022-0.029). Also, older children and children with brain injury were more likely to report experiencing headaches. CONCLUSIONS The findings from this study suggest an association between exposure to ACEs and headaches among children, and functional difficulties partially mediate this association.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Zachary Tarbet
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | | | - Catherine A LaBrenz
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Moses Okumu
- University of North Carolina, at Chapel Hill, School of Social Work, Chapel Hill, NC, USA
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16
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Orr SL, Powers SW. Virtual issue: Kids (with headache disorders) are not just little adults (with headache disorders). Headache 2021; 61:563-564. [PMID: 33891345 DOI: 10.1111/head.14090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 01/01/2023]
Affiliation(s)
- Serena L Orr
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Section of Neurology, Alberta Children's Hospital, Calgary, AB, Canada
| | - Scott W Powers
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Headache Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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17
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Uyar Cankay T, Besenek M. Negative effects of accompanying psychiatric disturbances on functionality among adolescents with chronic migraine. BMC Neurol 2021; 21:97. [PMID: 33658010 PMCID: PMC7927375 DOI: 10.1186/s12883-021-02119-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 02/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background Chronic migraine is a condition with gradually increasing prevalence among adolescents which causes severe headaches resulting in functionality loss. Factors contributing to migraine becoming chronic and negatively affecting quality of life in adolescence are still unclear. Parallel with these, we aimed to examine the effect of psychiatric symptoms on headache severity and functionality loss among adolescents with chronic migraine. Methods We evaluated features of 50 adolescents who were diagnosed with chronic migraine according to International Classification of Headache Disorders-3 for the first time in their lives by an experienced neurologist. Sociodemographic and clinical data were collected and Pediatric Migraine Disability Assessment Score, Visual Analogue Score and DSM-5 Level 1 Cross-Cutting Symptom Measure Scores (CCSM-5) were evaluated. Semi-structured psychiatric interviews were done to those who scored higher than cut-off scores on CCSM-5. Healthy control group was constituted of cases which had similar age and sex distribution to case group. Results Majority of the case group was female (%78). There was a positive correlation between headache severity and computerized tomography history in emergency department. All of the psychiatric symptom scores were significantly higher in case group except for psychotic symptoms; but attention problems and manic symptoms clusters did not have significant difference according to the thresholds of CCSM-5. Receiving a psychiatric diagnosis did not affect frequency, severity or duration of headaches. There were also no relationship between depression/anxiety diagnosis and severity of headache/functionality loss. Conclusion Findings suggest that; more rational treatment methods with lesser functionality loss should be developed by adopting multidisciplinary and prospective approach via psychiatric screening for adolescents with chronic migraine.
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Affiliation(s)
- Tugba Uyar Cankay
- Department of Neurology, Recep Tayyip Erdogan University, Faculty of Medicine, Rize, Turkey.
| | - Mert Besenek
- Department of Child and Adolescent Psychiatry, Recep Tayyip Erdogan University, Faculty of Medicine, Rize, Turkey
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18
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Raucci U, Boni A, Evangelisti M, Della Vecchia N, Velardi M, Ursitti F, Terrin G, Di Nardo G, Reale A, Villani A, Parisi P. Lifestyle Modifications to Help Prevent Headache at a Developmental Age. Front Neurol 2021; 11:618375. [PMID: 33603708 PMCID: PMC7884344 DOI: 10.3389/fneur.2020.618375] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
Headache is the world's seventh most significant cause of disability-adjusted-life in people aged between 10 and 14 years. Therapeutic management is based on pharmacological approaches and lifestyle recommendations. Many studies show associations between each migraine-promoting lifestyle, behavioral triggers, frequency, and intensity of headaches. Nevertheless, the overall aspects of this topic lack any definitive evidence. Educational programs advise that pediatric patients who suffer from migraines follow a correct lifestyle and that this is of the utmost importance in childhood, as it will improve quality of life and assist adult patients in avoiding headache chronicity, increasing general well-being. These data are important due to the scarcity of scientific evidence on drug therapy for prophylaxis during the developmental age. The "lifestyle recommendations" described in the literature include a perfect balance between regular sleep and meal, adequate hydration, limited consumption of caffeine, tobacco, and alcohol, regular physical activity to avoid being overweight as well as any other elements causing stress. The ketogenic diet is a possible new therapeutic strategy for the control of headache in adults, however, the possible role of dietary factors requires more specific studies among children and adolescents. Educational programs advise that the improvement of lifestyle as a central element in the management of pediatric headache will be of particular importance in the future to improve the quality of life of these patients and reduce the severity of cephalalgic episodes and increase their well-being in adulthood. The present review highlights how changes in different aspects of daily life may determine significant improvements in the management of headaches in people of developmental age.
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Affiliation(s)
- Umberto Raucci
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | | | - Melania Evangelisti
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Nicoletta Della Vecchia
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Margherita Velardi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Fabiana Ursitti
- Division of Neurology, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Gianluca Terrin
- Department of Gynecological Obstetric and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Giovanni Di Nardo
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Antonino Reale
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Pasquale Parisi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
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19
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Manzar MD, Salahuddin M, Pandi-Perumal SR, Bahammam AS. Insomnia May Mediate the Relationship Between Stress and Anxiety: A Cross-Sectional Study in University Students. Nat Sci Sleep 2021; 13:31-38. [PMID: 33447116 PMCID: PMC7802775 DOI: 10.2147/nss.s278988] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/25/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND High perceived stress and anxiety disorders are usually comorbid with each other, with stress often sequentially preceding the development of anxiety. While prior findings showed a causal role of sleep problems in anxiety, no study has assessed the role of insomnia as a mediator in the relationship between stress and anxiety. METHODS A cross-sectional study on university students (n = 475, age = 21.1+2.6 years) was conducted over 3 months. Participants completed self-report measures of Leeds Sleep Evaluation Questionnaire-Mizan (LSEQ-M), Perceived Stress Scale-10 (PSS-10), generalized anxiety disorder-7 scale (GAD-7), and a sociodemographic tool. The mediation effect model given by Baron and Kelly was used to determine the relationship. RESULTS The prevalence of insomnia and anxiety disorder was 43.6% and 21.9%, respectively. Stress was significantly associated with LSEQ-M (insomnia measure) (b = -.44, SE = 0.16, p<0.01), and high levels of anxiety (b = 0.25, SE = 0.03, p < 0.01). The indirect effect of stress on anxiety through LSEQ-M (insomnia measure) was significant (95% confidence interval [0.01, 0.04]). However, the indirect effect of anxiety on stress through LSEQ-M (insomnia measure) was non-significant (95% confidence interval [-.01, 0.04]). CONCLUSIONS Students having higher perceived stress levels and comorbid insomnia were also likely to have a higher anxiety level.
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Affiliation(s)
- Md Dilshad Manzar
- Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al Majmaah 11952, Saudi Arabia
| | - Mohammed Salahuddin
- Department of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University (Mizan Campus), Mizan-Aman, Ethiopia.,Pharmacology Division, Department of BioMolecular Sciences, University of Mississippi, Oxford, MS, USA
| | | | - Ahmed S Bahammam
- The University Sleep Disorders Center, College of Medicine, King Saud University, Riyadh 11324, Saudi Arabia.,National Plan for Science and Technology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Yamanaka G, Morichi S, Suzuki S, Go S, Takeshita M, Kanou K, Ishida Y, Oana S, Kawashima H. A Review on the Triggers of Pediatric Migraine with the Aim of Improving Headache Education. J Clin Med 2020; 9:jcm9113717. [PMID: 33228144 PMCID: PMC7699367 DOI: 10.3390/jcm9113717] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 12/18/2022] Open
Abstract
Although migraines are common in children and adolescents, they have a robustly negative impact on the quality of life of individuals and their families. The current treatment guidelines outline the behavioral and lifestyle interventions to correct common causative factors, such as negative emotional states, lack of exercise and sleep, and obesity; however, the evidence of their effectiveness is insufficient. To create a plan for disseminating optimal pediatric headache education, we reviewed the current evidence for factors correlated with migraine. We assessed three triggers or risk factors for migraines in children and adolescents: stress, sleep poverty, and alimentation (including diet and obesity). While there is a gradual uptick in research supporting the association between migraine, stress, and sleep, the evidence for diet-related migraines is very limited. Unless obvious dietary triggers are defined, clinicians should counsel patients to eat a balanced diet and avoid skipping meals rather than randomly limiting certain foods. We concluded that there is not enough evidence to establish a headache education plan regarding behavioral and lifestyle interventions. Clinicians should advise patients to avoid certain triggers, such as stress and sleep disorders, and make a few conservative dietary changes.
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