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Wang Y, Xu J, Ding C, Deng T, Shen Z, Huang W, Wan Y, Xing T. The Link Between Temporomandibular Disorders and Jaw Functional Limitations Among Chinese Adolescents. Int Dent J 2024:S0020-6539(24)01402-3. [PMID: 39142918 DOI: 10.1016/j.identj.2024.07.1206] [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: 04/23/2024] [Revised: 07/09/2024] [Accepted: 07/19/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Currently, there is still controversy surrounding the relationship between temporomandibular disorders (TMDs) symptoms and jaw functional limitations. We investigated the distribution of TMDs in senior high school students, including both the number and types of symptoms, and assessed their association with jaw functional limitations. Furthermore, we explored sex differences in these associations. METHODS This study was conducted at a public high school in Hefei, Anhui Province, China, with data collected from September to October 2022. All subjects completed questionnaires assessing the anamnestic symptoms of TMDs and the Jaw Functional Limitation Scale (JFLS), and examinations were performed by trained dentists according to the Diagnostic Criteria for TMD. Data were analysed using the Kruskal-Wallis, Mann-Whitney U, and Chi-square tests. RESULTS The mean age of the participants (N = 2890) was 17.2 ± 0.14 years and 38.9% were females (61.1% were males). Limitations in self-assessed jaw function were associated with the presence of TMDs (P < .05). Participants with more symptoms reported significantly high levels of functional limitations (P < .05). Compared to male adolescents, female adolescents more commonly experienced TMDs pain and tended to have more symptoms (P < .05). However, no sex differences were observed in most associations between TMDs and jaw functional limitations. CONCLUSION TMDs-positive symptoms are common in adolescents. Female adolescents were more affected by TMDs symptoms than male adolescents. Individuals with more TMDs symptoms have greater jaw functional limitations.
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Affiliation(s)
- Yifan Wang
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Jingyi Xu
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Chunmeng Ding
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Tongyan Deng
- Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Zhenguo Shen
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - WuanJing Huang
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China
| | - Yuhui Wan
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China; Teaching Center for Preventive Medicine, School of Public Health, Anhui Medical University, Hefei 230032, China.
| | - Tian Xing
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei 230032, China.
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2
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Lee S, Kim KR, Lee W. Exploring the link between pediatric headaches and environmental noise exposure. BMC Pediatr 2024; 24:94. [PMID: 38308216 PMCID: PMC10835846 DOI: 10.1186/s12887-023-04490-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/16/2023] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Headaches are the most common neurologic symptoms in the pediatric population. Most primary headache in children and adolescents focuses on associated factors, including noise. Auditory discomfort is related to recognizing the pain. We aimed to analyze the headache profile of pediatric populations and the connection between noise exposure and head pain in children and adolescents. METHODS We reviewed retrospectively medical records of the pediatric population with headaches in Gyeongsang National University Changwon Hospital from January 2022 to April 2023. Personal headache profiling from self-questionnaires and environmental noise data from the National Noise Information System (NNIS) were used to analyze each variable, and chi-square tests and linear regression models by SAS were used to analyze the statistical correlation. RESULTS Of the 224 participants, 125 were clinically diagnosed with headaches. Of the 104 pubertal subjects, 56.7% were diagnosed with headaches, compared to 60% in the prepubertal group. Both daytime and nighttime noise was significantly higher in the diagnosed headache group than in the non-diagnosed group. Headache duration increased by daytime and nighttime noise with statistical significance in age-adjusted models. CONCLUSION We found that noise exposure is correlated to headaches in children and adolescents. Daytime and nighttime environmental noise exposure was significantly associated with the duration of headaches through our data. Therefore, we assume that noise exposure is vitally relevant to prolonged headaches in the pediatric population. Further research is needed to improve our data.
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Affiliation(s)
- Sunho Lee
- Department of Pediatrics, CHA Ilsan Medical Center, CHA University, Goyang, Republic of Korea
| | - Kyung-Ran Kim
- Department of Pediatrics, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Wanhyung Lee
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
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3
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Togha M, Jafari E, Salami Z, Kamali K, Mirzaee Godarzee H, Mirzaee Godarzee M, Bavarnegin S. The prevalence and impact of tension-type headache in school-aged children in Iran. Front Neurol 2023; 14:1259624. [PMID: 37780714 PMCID: PMC10538125 DOI: 10.3389/fneur.2023.1259624] [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: 07/16/2023] [Accepted: 09/01/2023] [Indexed: 10/03/2023] Open
Abstract
Background Tension-Type Headache (TTH) is regarded as the third most prevalent disorder worldwide, prompting children to seek medical attention. Our objective is to investigate the prevalence of TTH among students aged 6 to 18 years in various geographical regions of Iran, while also assessing the impact of headaches on their quality of life. Methods Employing a cross-sectional survey, we have carefully distributed self-completed structured questionnaires to students in 121 meticulously selected schools throughout the country, ensuring the representation of its diverse population. Results Among the 2,958 potential participants, we have included a total of 2031 individuals in our study. This comprises 57.3% children and 42.7% adolescents, with 50.02% being males and 49.97% females. Specifically, we have examined 950 subjects with TTH and 1,081 individuals without any form of headache. TTH was diagnosed in 32.1% of the participants. Notably, we have observed a significant difference in the average age between the TTH subjects and those without headaches. Participants without headaches were more likely to be enrolled in primary schools, while those diagnosed with TTH predominantly attended high schools. We found no significant relationship between urban-rural areas or different geographic regions and the prevalence of TTH or its subtypes. Phonophobia was commonly associated with TTHs. Lastly, the mean quality-of-life score was highest for individuals without headaches, followed by those with low frequency episodic TTH, high frequency episodic TTH, and chronic TTHs. There was also a significant relation between headache severity and quality of life scores. Conclusion The significant prevalence of TTH in children and adolescents and its adverse impact on the daily activities of individuals underscore the utmost importance of accurate diagnosis and efficient management.
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Affiliation(s)
- Mansoureh Togha
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Jafari
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhale Salami
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Molecular Genetics, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - Koorosh Kamali
- School of Public Health, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Mohadeseh Mirzaee Godarzee
- Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran
| | - Sanaz Bavarnegin
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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4
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McGinley JS, Savord A, Buse DC, Wirth RJ, Lipton RB. Longitudinal assessment of comorbidities and co-occurring conditions in adolescents with migraine: A secondary analysis of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Headache 2023; 63:243-254. [PMID: 36794298 DOI: 10.1111/head.14457] [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: 12/21/2021] [Revised: 08/19/2022] [Accepted: 08/31/2022] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To investigate the links between adolescent migraine and comorbid and co-occurring conditions using a large, nationally representative longitudinal study. BACKGROUND Comorbidities and co-occurring conditions play an important role in the clinical treatment of individuals with migraine. Research in this area has focused largely on the adult population using cross-sectional data, but less is known about adolescents and how conditions may co-occur over time from a broader developmental perspective. The goals of this manuscript were to empirically evaluate the associations between adolescent migraine and several linked conditions and explore the relative timings of onset of these conditions from adolescence to adulthood. METHODS Data came from the National Longitudinal Study of Adolescent to Adult Health (Add Health), a school-based study of the health-related behaviors and conditions of adolescents. The present study examined data from Wave 1 (W1, study years: 1994-1995), Wave 4 (W4, study years: 2008-2009), and Wave 5 (W5, study years: 2016-2018). Analyses and visual plots were used to evaluate potential links between parent-reported adolescent migraine status (PR-AdMig) at W1 and 15 medical conditions identified based on self-reported medical diagnoses (SR-MDs) at W4 and W5. Based on prior literature in adults, we identified 11 conditions predicted to be associated with PR-AdMig and four conditions predicted not to be associated with PR-AdMig. The analyses were exploratory and post hoc. RESULTS The total sample size pooling over all analyses was n = 13,786, but the wave-specific sample sizes differed due to missing data (W4 analyses, n = 12,692; W5 analyses, n = 10,340); 7243/13,786 (unweighted: 52.5%; weighted: 50.5%) of participants were female, 7640/13,786 (unweighted: 55.4%; weighted: 68.6%) were White, and 1580/13,786 (unweighted: 11.5%; weighted: 12.0%) had PR-AdMig. The average ages were 15.8 years at W1, 28.7 years at W4, and 37.8 years at W5. Findings showed that PR-AdMig was associated with anxiety/panic disorder (W4: PR-AdMig vs. Control weighted %: 17.1% vs. 12.6%, unadjusted odds ratio [OR] = 1.43, 95% confidence interval [CI] 1.18-1.74, p = 0.0003; W5: 31.6% vs. 22.4%, OR = 1.60, 95% CI 1.28-2.02, p < 0.0001), asthma/chronic bronchitis/emphysema (W4: 20.0% vs. 14.7%, OR = 1.45, 95% CI 1.20-1.76, p < 0.001; W5: 21.0% vs. 14.6%, OR = 1.55, 95% CI 1.25-1.94, p < 0.001), attention deficit hyperactivity disorder (W4: 8.3% vs. 5.4%, OR = 1.58, 95% CI 1.18-2.10, p = 0.002), depression (W4: 23.7% vs. 15.4%, OR = 1.71, 95% CI 1.43-2.04, p < 0.0001; W5: 33.8% vs. 25.1%, OR = 1.53, 95% CI 1.22-1.90, p < 0.001), epilepsy/seizure disorder (W4: 2.2% vs. 1.2%, OR = 1.84, 95% CI 1.23-2.76, p = 0.004), migraine (W4: 38.8% vs. 11.9%, OR = 4.7, 95% CI 4.1-5.5, p < 0.001), post-traumatic stress disorder (W4: 4.1% vs. 2.8%, OR = 1.45, 95% CI 1.01-2.08, p = 0.042; W5: 11.3% vs. 7.1%, OR = 1.67, 95% CI 1.27-2.20, p < 0.001), and sleep apnea (W5: 11.0% vs. 7.6%, OR = 1.51, 95% CI 1.15-1.98, p = 0.003). Among theoretically unlinked conditions, only hepatitis C at W4 was shown to have a relationship with adolescent onset migraine (0.7% vs. 0.2%, OR = 3.63, 95% CI 1.32-10.0, p = 0.013). Visual plots suggested that the retrospective, self-report timing of onset of specific subsets of co-occurring conditions tended to group together over time. CONCLUSIONS Consistent with the existing headache literature, results showed that adolescent migraine was associated with other medical and psychological conditions and visual plots suggested that there may be developmental patterns in the occurrence of migraine with other related conditions.
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Affiliation(s)
- James S McGinley
- Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA
| | - Andrea Savord
- Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA.,Arizona State University, Tempe, Arizona, USA
| | - Dawn C Buse
- Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA.,Albert Einstein College of Medicine, Bronx, New York, USA
| | - R J Wirth
- Vector Psychometric Group, LLC, Chapel Hill, North Carolina, USA
| | - Richard B Lipton
- Albert Einstein College of Medicine, Bronx, New York, USA.,Montefiore Medical Center, Bronx, New York, USA
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Chatterjee JH, Blume HK. Migraine and Mental Health in Pediatrics. JAMA Pediatr 2022; 176:1165-1166. [PMID: 36315116 DOI: 10.1001/jamapediatrics.2022.3948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Jessica Hauser Chatterjee
- Center for Integrative Brain Research, Division of Pediatric Neurology, Department of Neurology, Seattle Children's Research Institute, University of Washington School of Medicine, Seattle
| | - Heidi K Blume
- Center for Integrative Brain Research, Division of Pediatric Neurology, Department of Neurology, Seattle Children's Research Institute, University of Washington School of Medicine, Seattle
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6
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Kim S. Pediatric headache: a narrative review. JOURNAL OF YEUNGNAM MEDICAL SCIENCE 2022; 39:278-284. [PMID: 36102115 PMCID: PMC9580058 DOI: 10.12701/jyms.2022.00528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/26/2022] [Indexed: 11/25/2022]
Abstract
Headache is one of the most common neurological disorders in children and adults and can cause significant distress and disability in children and their families. The spectrum of pediatric headaches is broad, and the underlying etiology is variable. The symptoms and phenotypes of headaches in children may differ slightly from those in adults. It is important to have a good understanding of headaches in children and to distinguish between primary and secondary headaches through appropriate history assessment and neurological examination. Accurate diagnosis and appropriate drug selection are helpful for effective treatment. This article reviews headaches in children and adolescents, focusing on approaches for diagnosis and management.
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Affiliation(s)
- Saeyoon Kim
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
- Corresponding author: Saeyoon Kim, MD Department of Pediatrics, Yeungnam University College of Medicine, 170 Hyunchungro, Nam-gu, Daegu 42415, Korea Tel: +82-53-620-3471 • Fax: +82-53-629-3533 • E-amil:
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7
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DiSabella M, Pierce E, McCracken E, Ratnaseelan A, Vilardo L, Borner K, Langdon R, Fletcher AA. Pediatric Headache Experience During the COVID-19 Pandemic. J Child Neurol 2022; 37:871-881. [PMID: 36000303 PMCID: PMC9412153 DOI: 10.1177/08830738221114240] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Headache disorders are exceedingly common in children and adolescents. The association between headaches, emotional stress, and disruptions in daily routines are well established. The goal of this study is to compare the experiences of patients with a preexisting diagnosis of a primary headache disorder in terms of headache frequency and severity, lifestyle techniques for headache prevention, screen use, and mood from before and after the onset of the COVID-19 pandemic. METHODS Patients evaluated by the Headache Clinic at Children's National Hospital between Summer 2020 and Winter 2021 were enrolled in a patient registry. Patients completed a questionnaire examining changes in headache characteristics and lifestyle factors since the onset of the COVID-19 pandemic. RESULTS A total of 107 patients completed the survey. Since the pandemic's onset, patients reported decreased physical activity (n = 59, 55%), increased frequency of chronic headaches from 40% (N = 42) to 50% (N = 54), and increased constant daily headaches from 22% (n = 24) to 36% (n = 38). Patients reported worsened anxiety (n = 58, 54%), mood (n = 50, 47%), and workload (n = 49, 46%). Sixty-one percent (n = 65) of patients reported using screens for school for more than 6 hours per day. The majority (n = 67, 63%) of patients indicated that they would prefer attending in-person school, with 14% (n = 15) responding that they preferred online school. CONCLUSION Since the COVID-19 pandemic's onset, pediatric headache patients have experienced increasing headache frequency, worsening anxiety and mood, decreased physical activity, and increased screen usage. Although this study is limited by sample size and observational design, future population-based studies will further elucidate the impact of this pandemic on pediatric headache.
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Affiliation(s)
- Marc DiSabella
- George Washington University School of
Medicine, Children’s National Hospital, Washington, DC, USA,Children’s National Hospital,
Washington, DC, USA
| | - Emily Pierce
- Children’s National Hospital,
Washington, DC, USA
| | - Emily McCracken
- Children’s National Hospital,
Washington, DC, USA,Emily McCracken, BA, Children’s National
Hospital, 111 Michigan Ave, NW, Washington, DC 20010, USA.
| | - Aarane Ratnaseelan
- George Washington University School of
Medicine, Children’s National Hospital, Washington, DC, USA
| | | | - Kelsey Borner
- Warren Alpert Medical School of Brown
University, Hasbro Children’s Hospital/Rhode Island Hospital, Providence, RI,
USA
| | - Raquel Langdon
- George Washington University School of
Medicine, Children’s National Hospital, Washington, DC, USA,Children’s National Hospital,
Washington, DC, USA
| | - Angela A. Fletcher
- George Washington University School of
Medicine, Children’s National Hospital, Washington, DC, USA,Children’s National Hospital,
Washington, DC, USA
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8
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Gibler RC, Knestrick KE, Reidy BL, Lax DN, Powers SW. Management of Chronic Migraine in Children and Adolescents: Where are We in 2022? Pediatric Health Med Ther 2022; 13:309-323. [PMID: 36110896 PMCID: PMC9470380 DOI: 10.2147/phmt.s334744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/10/2022] [Indexed: 11/23/2022] Open
Abstract
Migraine is a neurological disorder that affects millions of children and adolescents worldwide. Chronic migraine is a subtype of migraine in which patients experience headaches for more days than not each month, with accompanying symptoms of phonophobia, photophobia, nausea or vomiting for most of these headaches. The burden and impact of chronic migraine in the daily lives of children and adolescents is substantial, requiring a holistic, multidisciplinary, and biopsychosocial approach to conceptualization and treatment. The purpose of this review is to provide a comprehensive “2022” overview of acute and preventive treatments for the management of chronic migraine in youth. We first describe diagnostic criteria for chronic migraine and highlight the state of evidence for acute and preventive treatment in children and adolescents. We then discuss emerging treatments currently receiving rigorous clinical research effort, special considerations for the treatment of chronic migraine in children and adolescents, and avenues for improving existing treatments and expanding access to evidence-based care.
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Affiliation(s)
- Robert C Gibler
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Correspondence: Robert C Gibler, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA, Email
| | - Kaelynn E Knestrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Brooke L Reidy
- 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
| | - Daniel N Lax
- Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, 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
- Headache Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
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9
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Polese D, Belli A, Esposito D, Evangelisti M, Luchetti A, Di Nardo G, Parisi P, Bruni O. Psychological Disorders, Adverse Childhood Experiences and Parental Psychiatric Disorders in Children Affected by Headache: A Systematic Review. Neurosci Biobehav Rev 2022; 140:104798. [PMID: 35907492 DOI: 10.1016/j.neubiorev.2022.104798] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 07/23/2022] [Accepted: 07/24/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Pediatric headaches have been linked to adverse life events or psychological factors in children and their families, with a complex and bidirectional association. Moreover, it is well-known that psychological stress can trigger headaches. METHODS We searched three databases for studies focusing on headaches and adverse events or psychological factors in children up to 12 years old or in their caregivers. RESULTS We included 28 studies. Child psychological factors, including internal and external symptoms, were commonly associated with all types of headaches. Sleep disturbances showed a positive association with headaches in 3 out of 5 studies. Family conflict and unhappiness were frequently found in children suffering with headaches, while single-parent families and divorce were not associated. Stressful environments and adverse life events, particularly bullying, were also found to be linked with headaches. CONCLUSIONS Childhood headaches represent an alarm bell for clinicians to investigate and treat psychological or psychiatric disorders in children and their family. Further studies are needed to elucidate the role of early-life adverse events in children and their families.
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Affiliation(s)
- Daniela Polese
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), "Sapienza" University of Rome, Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Arianna Belli
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Via dei Sabelli 108 - 00185 Rome, Italy
| | - Dario Esposito
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Via dei Sabelli 108 - 00185 Rome, Italy
| | - Melania Evangelisti
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University c/o Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Anna Luchetti
- "Sapienza" University of Rome, Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Giovanni Di Nardo
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University c/o Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Pasquale Parisi
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University c/o Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Oliviero Bruni
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), "Sapienza" University of Rome, Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy; Department of Social and Developmental Psychology, Sapienza University, Via dei Marsi 78 - 00185 Rome, Italy.
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10
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Sangalli L, Gibler R, Boggero I. Pediatric Chronic Orofacial Pain: A Narrative Review of Biopsychosocial Associations and Treatment Approaches. FRONTIERS IN PAIN RESEARCH 2022; 2:790420. [PMID: 35295480 PMCID: PMC8915750 DOI: 10.3389/fpain.2021.790420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/02/2021] [Indexed: 12/28/2022] Open
Abstract
Pediatric chronic orofacial pain (OFP) is an umbrella term which refers to pain associated with the hard and soft tissues of the head, face, and neck lasting >3 months in patients younger than 18 years of age. Common chronic pediatric OFP diagnoses include temporomandibular disorder, headaches, and neuropathic pain. Chronic OFP can adversely affect youth's daily functioning and development in many areas of well-being, and may be associated with emotional stress, depression, functional avoidance, and poor sleep, among other negative outcomes. In this mini-review, we will discuss common psychological comorbidities and familial factors that often accompany chronic pediatric OFP conditions. We will also discuss traditional management approaches for pediatric orofacial pain including education, occlusal appliances, and psychological treatments such as relaxation, mindfulness-based interventions, and cognitive-behavioral treatments. Finally, we highlight avenues for future research, as a better understanding of chronic OFP comorbidities in childhood has the potential to prevent long-term pain-related disability in adulthood.
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Affiliation(s)
- Linda Sangalli
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, KY, United States
| | - Robert Gibler
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Ian Boggero
- Department of Oral Health Science, Division of Orofacial Pain, University of Kentucky, College of Dentistry, Lexington, KY, United States
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11
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Caruso A, Grolnick W, Mueller C, Kaczynski K, Chang CYH, Lebel A. Health Mindsets in Pediatric Chronic Headache. J Pediatr Psychol 2021; 47:391-402. [PMID: 34877604 DOI: 10.1093/jpepsy/jsab115] [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: 05/01/2021] [Revised: 10/12/2021] [Accepted: 10/12/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Given how frequently youth with chronic headache and migraine experience setbacks in treatment, identifying factors that promote coping and resilience is critical. Mindsets have gained attention as predictors of behavior and targets of intervention across contexts, including health. Health mindsets may help to explain how children with chronic pain interpret and respond to treatment. This study evaluated whether growth health mindsets might relate to adaptive outcomes in patients with chronic pediatric headache. METHODS Participants were 88 children and adolescents (ages 10-17 years) with headache or migraine contacted following an appointment at a pediatric headache clinic, and their parent. Patients rated their beliefs about health as more fixed versus growth-oriented. They were presented with vignettes depicting hypothetical treatment setbacks and instructed to reflect upon real-life setbacks. Patients completed questionnaires about their cognitive appraisals of setbacks, coping, quality of life, life satisfaction, and functional impairment. RESULTS The higher children rated their growth health mindsets, the less likely they were to appraise setbacks as threatening and endorse quality-of-life problems. Children with higher growth mindsets reported higher life satisfaction and lower functional disability. There was also an indirect relation between children's mindsets and coping through cognitive appraisals of setbacks as a threat, but not challenge. CONCLUSION This research extends the health mindsets literature by contributing preliminary evidence of health mindsets as tied to adaptive outcomes in youth with chronic headache. These findings may be of interest to clinicians and parents, as health mindsets may offer an avenue by which resilience is promoted and maladaptive appraisals are minimized.
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Affiliation(s)
- Alessandra Caruso
- Department of Psychology, Clark University, USA.,Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, USA
| | | | - Claudia Mueller
- Department of Surgery, Stanford University School of Medicine, USA
| | - Karen Kaczynski
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, USA.,Department of Psychiatry, Harvard Medical School, USA
| | - Cindy Yu-Hsing Chang
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, USA
| | - Alyssa Lebel
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, USA.,Department of Neurology, Harvard Medical School, USA
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12
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Salamon KS, Carlson M, Hildenbrand AK. Who Gets Referred? A Pilot Study of Risk Stratification and Treatment Referral in Pediatric Headache Using the Pediatric Pain Screening Tool. J Pediatr Psychol 2021; 47:403-411. [PMID: 34757430 DOI: 10.1093/jpepsy/jsab117] [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: 05/01/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Headaches are common among youth and are associated with significant negative outcomes. Despite advances in interdisciplinary treatments for youth with chronic pain, research suggests disparities in access to these services. METHODS A total of 186 youth (M = 14.19 years old, 70.8% female) presenting to a neurology appointment at a children's hospital system were screened using the Pediatric Pain Screening Tool (PPST), a brief, validated measure to identify youth that may benefit from additional pain management services. RESULTS Two-thirds of participants (n = 124, 66.7%) screened as medium or high risk on the PPST. Risk categorization did not vary by patient age or sex. A greater proportion of Hispanic/Latino patients were categorized as low-risk relative to non-Hispanic/Latino patients (55.6% vs. 30.1%), and a somewhat lower proportion of patients of color were categorized as medium-risk relative to White patients (14.0% vs. 30.5%). Three-quarters (n = 94, 75.8%) of patients who were screened as medium or high risk were not referred for any additional pain management services. Referrals did not vary by patient age or ethnicity. While not statistically significant, a lower proportion of males received referrals at both medium (8.3% vs. 17.6%) and high levels of risk (15.8% vs. 34.5%), and a greater proportion of youth of color who screened as medium risk received referrals relative to White youth categorized as medium risk (37.5% vs. 10.3%). CONCLUSION Future research should continue to explore factors influencing decision-making regarding referral to specialized pain management services for youth with headache.
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Affiliation(s)
- Katherine S Salamon
- Division of Behavioral Health, Department of Pediatrics, Nemours/A. I. duPont Hospital for Children, USA
| | - Megan Carlson
- Division of Behavioral Health, Department of Pediatrics, Nemours/A. I. duPont Hospital for Children, USA.,Center for Healthcare Delivery Science, Nemours Children's Health System, USA
| | - Aimee K Hildenbrand
- Division of Behavioral Health, Department of Pediatrics, Nemours/A. I. duPont Hospital for Children, USA.,Center for Healthcare Delivery Science, Nemours Children's Health System, USA
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13
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McGinley JS, Savord A, Houts CR, Wirth RJ, Lipton RB, Buse DC. What do people want to know about "Growing Up with Migraine"? Results of a preference survey of people with lived experience to guide future research. Cephalalgia 2021; 42:262-265. [PMID: 34404251 DOI: 10.1177/03331024211038526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In recent years, emphasis has been placed on conducting headache research that is patient-centered to more explicitly incorporate the input of people who live with headache diseases. The Growing Up with Migraine Study was developed with this intention using a two-step process: 1. develop and administer a survey to identify research areas that matter most to people with adolescent migraine and/or their caregivers and 2. use the survey results to guide future secondary data analyses. This brief report summarizes the survey results from 373 individuals impacted by adolescent migraine. Findings suggested that people with history of adolescent migraine and/or their caregivers are most interested in research about migraine comorbidities and effects on psychological/social/emotional health, along with health-related outcomes and family-related topics. Future quantitative studies are planned that will explore these patient-identified priorities through secondary data analysis of an existing dataset.
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Affiliation(s)
| | - Andrea Savord
- Vector Psychometric Group, LLC, Chapel Hill, NC, USA.,Arizona State University, Tempe, AZ, USA
| | | | - R J Wirth
- Vector Psychometric Group, LLC, Chapel Hill, NC, USA
| | - Richard B Lipton
- Albert Einstein College of Medicine, Bronx, NY, USA.,Montefiore Medical Center, Bronx, NY, USA
| | - Dawn C Buse
- Vector Psychometric Group, LLC, Chapel Hill, NC, USA.,Albert Einstein College of Medicine, Bronx, NY, USA
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14
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Sleep Disorders in Pediatric Migraine: A Questionnaire-Based Study. J Clin Med 2021; 10:jcm10163575. [PMID: 34441871 PMCID: PMC8396839 DOI: 10.3390/jcm10163575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 12/15/2022] Open
Abstract
There is a high comorbidity between migraine and sleep disorders (SD), with a mutual dependence between sleep and headache. This study aimed to analyze the relationship between headache features (migraine frequency and severity, migraine equivalents, use and efficacy of treatments) and sleep in pediatric migraine. Parents of children and adolescents with migraine completed the Children’s Sleep Habits Questionnaire (CSHQ) and the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) and answered questions about headache characteristics. The presence of SD was defined according to CSHQ score. SD were detected in 72.9% of 140 subjects, but only 5.0% already received a diagnosis. Patients with SD presented statistically significant higher headache frequency (p = 0.031) and higher prevalence of migraine equivalents (p = 0.007). A higher CSHQ total score was associated with higher frequency of severe attacks (p = 0.012) and lower acute drug efficacy (p = 0.003). Significant positive correlations of sleep onset delay, sleep duration and nightwakings subscales with migraine frequency emerged. Our findings indicate that SD are highly prevalent in pediatric migraine and frequently associated with a higher headache severity and lower response to acute therapy, but often remain underdiagnosed. Improving sleep quality could help to reduce migraine intensity and disability and vice versa.
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15
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Gazerani P. Migraine and Mood in Children. Behav Sci (Basel) 2021; 11:bs11040052. [PMID: 33919881 PMCID: PMC8070834 DOI: 10.3390/bs11040052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023] Open
Abstract
Migraine is one of the most prevalent headache disorders in children and negatively influences their quality of life. Physical, social, and school functioning are negatively affected. Mood changes are common in migraineurs and may happen before, during, or after a migraine headache. Children with migraine are not exempt from mood swings. The majority of mood changes occur during the prodromal phase, manifesting as a psychobiological response, e.g., difficulty thinking, trouble concentrating, irritability, higher or lower energy, confusion, and depression. A bi-directional relationship between migraine and mood has been proposed, but mechanisms are not clear. Collectively, a maladaptive stress response has been suggested to explain the inability to balance homoeostatic changes when facing various stressors. Recognizing mood changes and monitoring mood patterns in children with migraine, for example, by various apps and so-called mood monitors, is valuable for better management. A multidisciplinary intervention has been recommended to reduce migraine disability, improve coping strategies, and reduce chronification risks in children with migraine. Pharmacological and non-pharmacological strategies are both available and effective. Biofeedback, relaxation, and cognitive-behavioral therapy yield positive outcomes in pediatric migraine. Developing healthy lifestyle habits (diet, exercise, sleep) also seems to improve migraine in this population.
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Affiliation(s)
- Parisa Gazerani
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway;
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9229 Aalborg E, Denmark;
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16
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Tarantino S, Papetti L, Di Stefano A, Messina V, Ursitti F, Ferilli MAN, Sforza G, Moavero R, Vigevano F, Gentile S, Valeriani M. Anxiety, Depression, and Body Weight in Children and Adolescents With Migraine. Front Psychol 2020; 11:530911. [PMID: 33192771 PMCID: PMC7655930 DOI: 10.3389/fpsyg.2020.530911] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 09/28/2020] [Indexed: 12/23/2022] Open
Abstract
Background: There is a lack of studies that explore the possible association between body weight, psychological symptoms, and migraine severity in pediatric populations. The purpose of the study was to explore: (1) the association between body weight and the frequency of migraine attacks, (2) the possible differences in anxiety and depression symptoms according to the frequency of attacks and body weight, and (3) the possible mediating role of anxiety and/or depression in the association between body weight and frequency of migraine attacks in children. Methods: One hundred and eleven children/adolescents with migraine were included (47 boys and 64 girls; mean age 11.7; ±2.4 years). The patients were classified as: (1) high frequency patients, reporting from weekly to daily episodes and (2) low frequency patients, with ≤3 episodes per month. According to their body mass index percentiles, the patients were divided in “Normal weight” (from ≥5 to <85 percentile), “Overweight” (from ≥85 to <95 percentile), and “Obese” (≥95 percentile). Given the low number of obese patients, the overweight and obese groups were considered together in the “Overweight” group. Anxiety and depression symptoms were assessed by the Self-Administered Psychiatric Scales for Children and Adolescents (SAFA). Results: Fifty-four patients were normal in weight (49.6%), while 56 patients (50.4%) were overweight. The overweight patients showed a higher frequency of migraine attacks (64.7%; p < 0.05). Patients with a high frequency of attacks reported higher scores in all SAFA-Anxiety subscales (SAFA-A Tot: F = 15.107; p = 0.000). Overweight patients showed a significantly higher score in the “Separation anxiety” subscale (F = 7.855; p = 0.006). We found a mediating role between the overweight and high frequency for total anxiety (z = 2.11 ± 0.03; p < 0.05) and social anxiety (z = 2.04 ± 0.03; p < 0.05). Conclusions: Our results suggest that, among the children suffering from migraine, the overweight status is associated with a higher frequency of attacks and separation anxiety symptoms. In particular, our study provides the first evidence of the role of anxiety in linking overweight and the frequency of migraine attacks in children and adolescents.
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Affiliation(s)
- Samuela Tarantino
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Laura Papetti
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Alessandra Di Stefano
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Valeria Messina
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Fabiana Ursitti
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Michela Ada Noris Ferilli
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Giorgia Sforza
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Romina Moavero
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Federico Vigevano
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Simonetta Gentile
- Unit of Clinical Psychology, Department of Neuroscience and Neurorehabilitation, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Massimiliano Valeriani
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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17
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Papetti L, Loro PAD, Tarantino S, Grazzi L, Guidetti V, Parisi P, Raieli V, Sciruicchio V, Termine C, Toldo I, Tozzi E, Verdecchia P, Carotenuto M, Battisti M, Celi A, D'Agnano D, Faedda N, Ferilli MA, Grillo G, Natalucci G, Onofri A, Pelizza MF, Ursitti F, Vasta M, Velardi M, Balestri M, Moavero R, Vigevano F, Valeriani M. I stay at home with headache. A survey to investigate how the lockdown for COVID-19 impacted on headache in Italian children. Cephalalgia 2020; 40:1459-1473. [PMID: 33146039 PMCID: PMC7684684 DOI: 10.1177/0333102420965139] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective The present Italian multicenter study aimed at investigating whether the course of primary headache disorders in children and adolescents was changed during the lockdown necessary to contain the COVID-19 emergency in Italy. Methods During the lockdown, we submitted an online questionnaire to patients already diagnosed with primary headache disorders. Questions explored the course of headache, daily habits, psychological factors related to COVID-19, general mood and school stress. Answers were transformed into data for statistical analysis. Through a bivariate analysis, the main variables affecting the subjective trend of headache, and intensity and frequency of the attacks were selected. The significant variables were then used for the multivariate analysis. Results We collected the answers of 707 patients. In the multivariate analysis, we found that reduction of school effort and anxiety was the main factor explaining the improvement in the subjective trend of headache and the intensity and frequency of the attacks (p < 0.001). The greater the severity of headache, the larger was the clinical improvement (p < 0.001). Disease duration was negatively associated with the improvement (p < 0.001). It is noteworthy that clinical improvement was independent of prophylaxis (p > 0.05), presence of chronic headache disorders (p > 0.05) and geographical area (p > 0.05). Conclusions Our study showed that lifestyle modification represents the main factor impacting the course of primary headache disorders in children and adolescents. In particular, reduction in school-related stress during the lockdown was the main factor explaining the general headache improvement in our population.
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Affiliation(s)
- Laura Papetti
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Samuela Tarantino
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Licia Grazzi
- Headache Center, Neuroalgology Department, IRCCS Foundation "Carlo Besta" Neurological Institute, Milan, Italy
| | - Vincenzo Guidetti
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Pasquale Parisi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Vincenzo Raieli
- Child Neuropsychiatry Unit - Ismep - ARNAS Civico, Palermo, Italy
| | - Vittorio Sciruicchio
- Children Epilepsy and EEG Center, PO, San Paolo ASL (Azienda Sanitaria Locale), Bari, Italy
| | - Cristiano Termine
- Department of Medicine and Surgery, University of Insubria and ASST dei Sette Laghi, Varese, Italy
| | - Irene Toldo
- Centro Cefalee per l'età Evolutiva, Dipartimento di Salute della Donna e del Bambino, Università degli Studi, Azienda Ospedaliera di Padova, Padova, Italy
| | - Elisabetta Tozzi
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'ambiente, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Paola Verdecchia
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Marco Carotenuto
- Neuropsichiatria Infantile, Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Matteo Battisti
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Angela Celi
- Department of Medicine and Surgery, University of Insubria and ASST dei Sette Laghi, Varese, Italy
| | - Daniela D'Agnano
- Children Epilepsy and EEG Center, PO, San Paolo ASL (Azienda Sanitaria Locale), Bari, Italy
| | - Noemi Faedda
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Michela An Ferilli
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Giovanni Grillo
- Child Neuropsychiatry Unit - Ismep - ARNAS Civico, Palermo, Italy
| | - Giulia Natalucci
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Agnese Onofri
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'ambiente, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Maria Federica Pelizza
- Centro Cefalee per l'età Evolutiva, Dipartimento di Salute della Donna e del Bambino, Università degli Studi, Azienda Ospedaliera di Padova, Padova, Italy
| | - Fabiana Ursitti
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Michelangelo Vasta
- Unità di Neuropsichiatroia Infantile, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Margherita Velardi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Martina Balestri
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Romina Moavero
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy.,Unità di Neuropsichiatroia Infantile, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Federico Vigevano
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Massimiliano Valeriani
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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18
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Landgraf MN, Kainz C, Gerstl L, Klose B, Mathonia N, Bonfert M, Ruscheweyh R, Straube A, von Mutius S, von Kries R, Heinen F. Kinder mit Migräne. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-00994-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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19
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Boppana SS, Miller R, Wrona A, Tumin D, Wrona S, Smith TP, Bhalla T, Kim SS, Tobias JD. Barriers to Outpatient Pediatric Chronic Pain Clinic Participation Among Referred Patients. Clin Pediatr (Phila) 2020; 59:859-864. [PMID: 32425071 DOI: 10.1177/0009922820922847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Initial clinic evaluation among referred patients and factors limiting treatment initiation are not well characterized. We conducted a retrospective review of referrals to our outpatient pain clinic to identify intake visits and factors associated with treatment initiation among adolescents with chronic pain. We identified adolescents aged 13 to 18 years at the time of referral to clinic (2010-2016). Factors associated with completion of visits were evaluated using logistic regression. Patients who completed visits more frequently had private insurance than public or no insurance (P = .053). The most common reasons for caregiver decision not to attend the pain clinic included use of another pain clinic, that services were not wanted or no longer needed, and that their child was undergoing further testing. The current study demonstrated that patients with head pain were more likely to complete an intake visit, while there was a trend showing that lack of private insurance decreased this likelihood.
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Affiliation(s)
| | | | - Aubrey Wrona
- Nationwide Children's Hospital, Columbus, OH, USA
| | | | - Sharon Wrona
- Nationwide Children's Hospital, Columbus, OH, USA
| | - Timothy P Smith
- Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | - Tarun Bhalla
- Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
| | | | - Joseph D Tobias
- Nationwide Children's Hospital, Columbus, OH, USA.,The Ohio State University, Columbus, OH, USA
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20
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CENTAURI F, PAMMOLLI A, SIMI R, DALMASSO P, BERCHIALLA P, BORRACCINO A, CHARRIER L, LENZI M, VIENO A, LEMMA P, CAVALLO F, LAZZERI G. Self-reported recurrent pain and medicine use among 15-year-olds: results from the HBSC Italian study. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E368-E375. [PMID: 31967095 PMCID: PMC6953457 DOI: 10.15167/2421-4248/jpmh2019.60.4.1382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/17/2019] [Indexed: 11/21/2022]
Abstract
Background The prevalence of adolescent pain varies considerably across epidemiological studies, and little information is available on pain-related behaviours among adolescents, including medicine use. The aims of this study were: [1] to examine the prevalence of recurrent pain among 15-year-old adolescents in Italy; [2] to investigate the association between recurrent pain and medicine use among boys and girls; and [3] to evaluate the consistency of these associations across Regions. Methods The World Health Organization (WHO) collaborative International Health Behaviour in School-aged Children 2013/2014 study collected self-reported data on pain and medicine use from 13611 15-year-old adolescents in 21 Italian Regions. We used multi-level multivariate logistic regression, stratified by gender, to analyse the association between recurrent pain and medicine use for headache, stomachache, nervousness and difficulties in getting to sleep. Results On average, across all Regions, almost 45% of adolescents reported recurrent headache, more than 30% reported recurrent backache and approximately 30% reported recurrent stomachache. Although the prevalence of both pain and medicine use was much higher among girls, the association between pain and medicine use was similarly strong in adolescents of both genders. Adolescents with recurrent pain proved more likely to use medicines also for non-corresponding pain, nervousness and difficulties in getting to sleep. The association between recurrent pain and medicine use was consistent across Regions despite large inter-regional differences in the prevalence of both phenomena. Conclusions Recurrent pain in adolescence is common nationwide. Adolescents with recurrent pain are more likely to use medicines in general. Recurrent pain and medicine use should be addressed by adolescent health policies.
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Affiliation(s)
- F. CENTAURI
- Hospital Direction, Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Correspondence: Federica Centauri, Azienda Ospedaliera Universitaria Senese, strada delle Scotte 14, 53100 Siena - Tel. +39 0577 585168 - E-mail:
| | - A. PAMMOLLI
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - R. SIMI
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - P. DALMASSO
- Department of Public Health and Paediatrics, University of Torino, Italy
| | - P. BERCHIALLA
- Department of Clinical and Biological Sciences, University of Torino, Italy
| | - A. BORRACCINO
- Department of Public Health and Paediatrics, University of Torino, Italy
| | - L. CHARRIER
- Department of Public Health and Paediatrics, University of Torino, Italy
| | - M. LENZI
- Department of Developmental and Social Psychology, University of Padova, Italy
| | - A. VIENO
- Department of Developmental and Social Psychology, University of Padova, Italy
| | - P. LEMMA
- Department of Public Health and Paediatrics, University of Torino, Italy
| | - F. CAVALLO
- Department of Public Health and Paediatrics, University of Torino, Italy
| | - G. LAZZERI
- Hospital Direction, Azienda Ospedaliera Universitaria Senese, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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21
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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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22
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Migraine and associated comorbidities are three times more frequent in children with ADHD and their mothers. Brain Dev 2018; 40:857-864. [PMID: 29921473 DOI: 10.1016/j.braindev.2018.06.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 04/23/2018] [Accepted: 06/03/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Attention deficit and hyperactivity disorder (ADHD) is a neuro-developmental disorder related to internalizing and externalizing disorders as well as somatic complaints and disorders. This study was conducted to evaluate the prevalence of headache subtypes, epilepsy, atopic disorders, motion sickness and recurrent abdominal pain among children and adolescents with ADHD and their parents. METHODS In a multi-center, cross-sectional, familial association study using case-control design, treatment naïve children and adolescents between 6 and 18 years of age diagnosed with ADHD according to the DSM-5 criteria as well as age- and gender-matched healthy controls and their parents were evaluated by a neurologist and analyzed accordingly. RESULTS 117 children and adolescents with ADHD and 111 controls were included. Headache disorder diagnosis was common for both patients and healthy controls (59.0% vs. 37.8%), with a significantly elevated rate in the ADHD group (p = 0.002). Migraine was found in 26.0% of ADHD patients and 9.9% of healthy controls. Tension headache was found in 32.4% of ADHD patients and 27.9% of healthy controls. Headache diagnosis was also found to be significantly more common in mothers of children with ADHD than control group mothers (90.5% vs. 36.6%, p < 0.001). CONCLUSION Headache diagnoses and specifically migraines were significantly more common among children with ADHD and their mothers, while recurrent abdominal pain was elevated in both parents and ADHD patients. Migraine is an important part of ADHD comorbidity, not only for children but also for mothers. Motion sickness may be reduced among families of ADHD probands.
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Larsson B, Sigurdson JF, Sund AM. Long-term follow-up of a community sample of adolescents with frequent headaches. J Headache Pain 2018; 19:79. [PMID: 30182167 PMCID: PMC6123329 DOI: 10.1186/s10194-018-0908-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Several outcome studies have reported on the short- and long-term effects of migraine in selected clinical samples of children and adolescents. However, current knowledge of the course, incidence, and outcome predictors of frequent headaches in early adolescents in community populations is limited, and little is known about the long-term effects. Headache remains untreated in most of these young people. Here we examined the course, incidence, and outcome predictors of frequent headaches (at least once a week) over the long term (14 years) using previously assessed data at the baseline and 1-year follow-up of early adolescents. Methods Out of an original sample of 2440 who participated in the first two assessments, a sample of 1266 participants (51.9% response rate) aged 26–28 years (mean = 27.2 years) completed an electronic questionnaire comprising questions about their headache frequency and duration at the long-term follow-up. These headache characteristics together with gender, age, parental divorce, number of friends, school absence, impairment of leisure-time activities and seeing friends, pain comorbidity, and emotional (in particular, depressive symptoms) and behavioral problems were analyzed. Results In these young people, 8.4% reported frequent headaches (at least once a week) at the extended follow-up, while 19% of the participants having such headaches at baseline again reported such levels with a negligible gender difference. Over the follow-up period, 7.4% had developed frequent headaches, and a higher percentage of females reported such headaches (11.3% in females, 1.5% in males). In a multivariate model, frequent headaches at the baseline, gender (worse prognosis in females), impairment of leisure-time activities and seeing friends, and higher level of depressive symptoms significantly predicted headache frequency at the long-term follow-up. Conclusions Our findings suggest that gender, greater social impairment, and comorbid depressive symptoms are important indicators for both the short- and long-term prognosis of frequent headaches in early adolescents in community populations.
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Affiliation(s)
- Bo Larsson
- Regional Center for Child and Youth Mental Health and Child Welfare - Central Norway, NTNU, Klostergat. 46/48, N-7489, Trondheim, Norway.
| | - Johannes Foss Sigurdson
- Regional Center for Child and Youth Mental Health and Child Welfare - Central Norway, NTNU, Klostergat. 46/48, N-7489, Trondheim, Norway
| | - Anne Mari Sund
- Regional Center for Child and Youth Mental Health and Child Welfare - Central Norway, NTNU, Klostergat. 46/48, N-7489, Trondheim, Norway
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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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Temporomandibular Disorders among Dutch Adolescents: Prevalence and Biological, Psychological, and Social Risk Indicators. Pain Res Manag 2018; 2018:5053709. [PMID: 29849843 PMCID: PMC5932427 DOI: 10.1155/2018/5053709] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 03/27/2018] [Indexed: 11/18/2022]
Abstract
Aims To assess the prevalence rates of pain-related temporomandibular disorders (TMDs) and temporomandibular joint (TMJ) sounds in a large group of Dutch adolescents, aged between 12 and 18 years and to determine if the same biological, psychological, and social risk indicators are related to both TMD pain and TMJ sounds. Methods In this cross-sectional questionnaire survey, 4,235 questionnaires were analyzed, with an about equal gender distribution. Results The overall prevalence of pain-related TMDs was 21.6% (26.1% for girls and 17.6% for boys) and that of TMJ sounds was 15.5% (19.3% for girls and 11.7% for boys). Logistic regression analyses revealed that the following variables appeared to be the strongest predictors of TMD pain: female gender, increasing age, sleep bruxism, biting on lips and/or cheeks, stress, and feeling sad. Regarding self-reported TMJ sounds, the multiple regression model revealed that female gender, increasing age, awake bruxism, and biting on lips and/or cheeks were the strongest predictors. Conclusions TMDs are a common finding among Dutch adolescents. Except for the psychological factors that appeared to be associated with TMD pain only, pain-related TMDs and TMJ sounds shared similar biological risk indicators.
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Balottin L, Mannarini S, Candeloro D, Mita A, Chiappedi M, Balottin U. Rorschach Evaluation of Personality and Emotional Characteristics in Adolescents With Migraine Versus Epilepsy and Controls. Front Neurol 2018; 9:160. [PMID: 29615959 PMCID: PMC5869322 DOI: 10.3389/fneur.2018.00160] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 03/05/2018] [Indexed: 01/24/2023] Open
Abstract
The literature examining primary headache, including migraine, in adolescents, has pointed out the key role played by a wide range of psychiatric disorders in reducing the patients’ quality of life. Moreover, pioneering studies showed that preexisting personality characteristics, specific emotion regulation styles and psychological-psychiatric difficulties are likely to increase the risk of the onset, maintenance, and outcome of headache. Still personality issues in migraine have been poorly studied, in particular in children and adolescents. This study aims, therefore, to investigate the specific characteristics of personality, and in particular emotion regulation and coping strategies, in adolescent with migraine, comparing them with age-matched patients with idiopathic epilepsy and healthy adolescents. 52 adolescents (age: 11–17) were assessed using a multi-method test battery, which included a self-report questionnaire (the youth self-report), a proxy-report (child behavior checklist) along with a projective personality test, the Rorschach Test, administered and scored according to the Exner comprehensive system. The results showed specific personality characteristics in adolescents with migraine, revealing a marked difficulty in modulating and regulating affections through thoughts and reflections, resorting instead to impulsive acts and maladaptive coping strategies, thus revealing a vague and immature perception of reality. Differently from adolescents belonging to the general population, but similarly to patients with epilepsy, adolescents with migraine perceive a high situational stress, probably related to the condition of suffering from chronic disease. They have, therefore, a lower self-consideration and self-esteem along with a poorer insight regarding themselves as well as the relations with others. In line with previous findings, these preliminary results suggest the need for further research on ample samples, using also standardized projective test in order to better understand the pathogenesis of psychological difficulties in patients with migraine. As a clinical implication, the results seem to indicate that providing a psychological integrated approach can play a pivotal role in the assessment and treatment of adolescent with migraine, in order to improve the outcome and the quality of life of the young patients.
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Affiliation(s)
- Laura Balottin
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Stefania Mannarini
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Daniela Candeloro
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Alda Mita
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Matteo Chiappedi
- Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Umberto Balottin
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Child Neuropsychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
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27
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Tarantino S, Papetti L, De Ranieri C, Boldrini F, Rocco AM, D’Ambrosio M, Valeriano V, Battan B, Paniccia MF, Vigevano F, Gentile S, Valeriani M. Maternal Alexithymia and Attachment Style: Which Relationship with Their Children's Headache Features and Psychological Profile? Front Neurol 2018; 8:751. [PMID: 29403425 PMCID: PMC5786507 DOI: 10.3389/fneur.2017.00751] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/28/2017] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION A growing body of literature has shown an association between somatic symptoms and insecure "attachment style." In a recent study, we found a relationship between migraine severity, ambivalent attachment style, and psychological symptoms in children/adolescents. There is evidence that caregivers' attachment styles and their way of management/expression of emotions can influence children's psychological profile and pain expression. To date, data dealing with headache are scarce. Our aim was to study the role of maternal alexithymia and attachment style on their children's migraine severity, attachment style, and psychological profile. MATERIALS AND METHODS We enrolled 84 consecutive patients suffering from migraine without aura (female: 45, male: 39; mean age 11.8 ± 2.4 years). According to headache frequency, children/adolescents were divided into two groups: (1) high frequency (patients reporting from weekly to daily attacks), and (2) low frequency (patients having ≤3 episodes per month). We divided headache attacks intensity into two groups (mild and severe pain). SAFA "Anxiety," "Depression," and "Somatization" scales were used to explore children's psychological profile. To evaluate attachment style, the semi-projective test SAT for patients and ASQ Questionnaire for mothers were employed. Maternal alexithymia traits were assessed by TAS-20. RESULTS We found a significant higher score in maternal alexithymia levels in children classified as "ambivalent," compared to those classified as "avoiding" (Total scale: p = 0.011). A positive correlation has been identified between mother's TAS-20 Total score and the children's SAFA-A Total score (p = 0.026). In particular, positive correlations were found between maternal alexithymia and children's "Separation anxiety" (p = 0.009) and "School anxiety" (p = 0.015) subscales. Maternal "Externally-oriented thinking" subscale correlated with children's school anxiety (p = 0.050). Moreover, we found a correlation between TAS-20 Total score and SAFA-D "Feeling of guilt" subscale (p = 0.014). Our data showed no relationship between TAS-20 and ASQ questionnaires and children's migraine intensity and frequency. CONCLUSION Maternal alexithymia and attachment style have no impact on children's migraine severity. However, our results suggest that, although maternal alexithymic traits have no causative roles on children's migraine severity, they show a relationship with patients' attachment style and psychological symptoms, which in turn may impact on migraine severity.
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Affiliation(s)
- Samuela Tarantino
- Division of Neurology, Headache Center, Bambino Gesù Ospedale Pediatrico (IRCCS), Rome, Italy
| | - Laura Papetti
- Division of Neurology, Headache Center, Bambino Gesù Ospedale Pediatrico (IRCCS), Rome, Italy
| | - Cristiana De Ranieri
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Francesca Boldrini
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Angela Maria Rocco
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Monica D’Ambrosio
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Valeria Valeriano
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Barbara Battan
- Division of Neurology, Headache Center, Bambino Gesù Ospedale Pediatrico (IRCCS), Rome, Italy
| | | | - Federico Vigevano
- Division of Neurology, Headache Center, Bambino Gesù Ospedale Pediatrico (IRCCS), Rome, Italy
| | - Simonetta Gentile
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù (IRCCS), Rome, Italy
| | - Massimiliano Valeriani
- Division of Neurology, Headache Center, Bambino Gesù Ospedale Pediatrico (IRCCS), Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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28
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Holstein BE, Andersen A, Denbaek AM, Johansen A, Michelsen SI, Due P. Short communication: Persistent socio-economic inequality in frequent headache among Danish adolescents from 1991 to 2014. Eur J Pain 2018; 22:935-940. [PMID: 29349882 DOI: 10.1002/ejp.1179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND The association between socio-economic status (SES) and headache among adolescents is an understudied issue, and no study has examined whether such an association changes over time. The aim was to examine trends in socio-economic inequality in frequent headache among 11- to 15-year-olds in Denmark from 1991 to 2014, using occupational social class (OSC) as indicator of SES. METHODS The study applies data from the Danish part of the international Health Behaviour in School-aged Children (HBSC) study. HBSC includes nationally representative samples of 11-, 13- and 15-year-olds. This study combines data from seven data survey years from 1991 to 2014, participation rate 88.6%, n = 31,102. We report absolute inequality as per cent difference in frequent headache between high and low OSC and relative inequality as odds ratio for frequent headache by OSC. RESULTS In the entire study population, 10.4% reported frequent headache. There was a significant increase in frequent headache from 8.0% in 1991 to 12.9% in 2014, test for trend, p < 0.0001. This increasing trend was significant in all OSCs. The prevalence of frequent headache was significantly higher in low than high OSC, OR = 1.50 (95% CI: 1.34-1.67). This socio-economic inequality in frequent headache was persistent from 1991 to 2014. CONCLUSION There was a significant and persistent socio-economic inequality, i.e. increasing prevalence of frequent headache with decreasing OSC. The association between socio-economic position and headache did not significantly change over time, i.e. the statistical interaction between OSC and survey year was insignificant. SIGNIFICANCE The prevalence of frequent headache among adolescents increases with decreasing SES. This socio-economic inequality has been persistent among adolescents in Denmark from 1991 to 2014. Clinicians should be aware of this social inequality.
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Affiliation(s)
- B E Holstein
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - A Andersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - A M Denbaek
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - A Johansen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - S I Michelsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - P Due
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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29
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Gray NJ, Wood DM. The Role of Medication in Supporting Emotional Wellbeing in Young People with Long-Term Needs. Healthcare (Basel) 2017; 5:E84. [PMID: 29099742 PMCID: PMC5746718 DOI: 10.3390/healthcare5040084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/20/2017] [Accepted: 10/29/2017] [Indexed: 11/20/2022] Open
Abstract
Young people frequently use and access prescribed medications for a range of health problems. Medications aimed at treating both common health problems and long-term physical and mental health needs in adolescence can have a significant effect on a young person's emotional well-being. We use a series of case studies to illustrate the challenges for healthcare professionals supporting young people with medication use. The studies illustrate the efficacy and limitations of medication on improving emotional well-being by alleviating illness and distress, and how this efficacy must be balanced against both the adverse effects and the burden of treatment. There are specific challenges for medication management during adolescence including issues of adherence/concordance, facilitating autonomy and participation in decision making, and promoting independence.
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Affiliation(s)
- Nicola J Gray
- Green Line Consulting Limited, Manchester M28 7FF, UK.
| | - Damian M Wood
- Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH, UK.
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30
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Heathcote LC, Rabner J, Lebel A, Hernandez JM, Simons LE. Rapid Screening of Risk in Pediatric Headache: Application of the Pediatric Pain Screening Tool. J Pediatr Psychol 2017; 43:243-251. [DOI: 10.1093/jpepsy/jsx123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 09/19/2017] [Indexed: 02/01/2023] Open
Affiliation(s)
- Lauren C Heathcote
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University
| | - Jonathan Rabner
- Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children’s Hospital
| | - Alyssa Lebel
- Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children’s Hospital
| | - Jessica M Hernandez
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University
| | - Laura E Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University
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31
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The role of attachment insecurity in the emergence of anxiety symptoms in children and adolescents with migraine: an empirical study. J Headache Pain 2017; 18:62. [PMID: 28560542 PMCID: PMC5449355 DOI: 10.1186/s10194-017-0769-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 05/22/2017] [Indexed: 01/03/2023] Open
Abstract
Background It is widely recognised that there are associations between headache, psychiatric comorbidity and attachment insecurity in both adults and children. The aims of this study were: 1) to compare perceived attachment security and anxiety in children and adolescents with migraine without aura and a healthy control group; 2) to test whether the child’s perceived security of attachment to the mother and the father mediated the association between migraine and anxiety. Methods One hundred children and adolescents with Migraine without Aura were compared with a control group of 100 children without headache. The Security Scale (measures perceived security of attachments) and the Self-Administered Psychiatric Scales for Children and Adolescents, a measure of anxiety symptoms, were administered to all participants. Results The clinical group had lower attachment security than the control group and higher scores on all anxiety scales. Anxiety was negatively correlated with attachment. Children’s attachment to their mother mediated the increase in global anxiety in the clinical group. Insecure paternal attachment was associated with greater insecurity in maternal attachment, suggesting that there is a complex pathway from migraine to anxiety symptoms mediated by perceived insecurity of paternal attachment and hence also by perceived insecurity of maternal attachment. Conclusion These results suggest that insecure parental attachment may exacerbate anxiety in children and adolescents with migraine and point to the importance of multimodal interventions, perhaps taking account of family relationships, for children and adolescents with migraine.
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Tarantino S, De Ranieri C, Dionisi C, Gagliardi V, Paniccia MF, Capuano A, Frusciante R, Balestri M, Vigevano F, Gentile S, Valeriani M. Role of the Attachment Style in Determining the Association Between Headache Features and Psychological Symptoms in Migraine Children and Adolescents. An Analytical Observational Case-Control Study. Headache 2017; 57:266-275. [PMID: 28058729 DOI: 10.1111/head.13007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/19/2016] [Accepted: 10/06/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVE We aimed to study the role of attachment style on headache severity and psychological symptoms in migraineurs children/adolescents. Moreover, we investigated the association between attachment style, migraine severity, and psychological symptoms. BACKGROUND Attachment theory suggests that early interpersonal relationships may be important determinants of psychopathology and pain management. In particular, individuals with insecure attachment styles have been shown to experience more pain than people with secure attachment style. Few studies focused on headache and data on attachment style in pediatric headache are scarce. METHODS We studied 90 migraineurs (mean age 12.2 ± 2.6 years; female: 54, male: 36). Patients were divided in two groups according to headache attack frequency: (1) high frequency (HF) patients, having from weekly to daily episodes and (2) low frequency (LF) patients, showing ≤3 episodes per month. According to headache attack intensity, patients were classified in two groups: (1) mild pain (MP), allowing the patient to continue his/her daily activities and (2) severe pain (SP), leading to interruption of patient activities or forcing the child to go to bed. The psychological screening was assessed by SAFA Anxiety, Depression, and Somatization questionnaires. Attachment style was measured by the semi-projective test Separation Anxiety Test. Patients were divided into "secure," "avoidant," "ambivalent," and "disorganized/confused" attachment patterns. RESULTS We found a significant relationship between the attachment style and migraine features. The ambivalent attachment was the most common style among patients reporting high attack frequency (51%) and severe pain intensity (50%). Anxiety (SAFA-A Tot: F = 23.3, P < .001), depression (SAFA-D Tot: F = 11.8, P < .001), and somatization (SAFA-S Tot: F = 10.1, P < .001) were higher in patients with ambivalent attachment style. Moreover, our results showed an association between high attack frequency and high anxiety levels, in children with ambivalent attachment style (F = 6.7, P < .002). CONCLUSIONS Ambivalent attachment style may be a common vulnerability factor that impacts on pain severity, anxiety, depression, and somatization symptoms in young migraineurs. In particular, the present study provides the first evidence of the role of insecure attachment on the relationship between pain severity and psychological symptoms in migraine children.
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Affiliation(s)
- Samuela Tarantino
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Cristiana De Ranieri
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Cecilia Dionisi
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Valentina Gagliardi
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | | | - Alessandro Capuano
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Roberto Frusciante
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Martina Balestri
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Federico Vigevano
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Simonetta Gentile
- Unit of Clinical Psychology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - Massimiliano Valeriani
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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33
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Affiliation(s)
- Yun-Jin Lee
- Department of Pediatrics, Pusan National University School of Medicine, Yangsan, Korea
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34
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Russo A, Bruno A, Trojsi F, Tessitore A, Tedeschi G. Lifestyle Factors and Migraine in Childhood. Curr Pain Headache Rep 2016; 20:9. [PMID: 26757711 DOI: 10.1007/s11916-016-0539-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Migraine is one of the most common pain symptoms in children. Indeed, a high percentage of adult migraine patients report to have suffered from recurrent headache during the childhood. In particular, children could experience the so-called childhood periodic syndromes (such as cyclic vomiting, abdominal migraine, and benign paroxysmal vertigo) that have been usually considered precursors of migraine or they could develop overt migraine headaches. However, typical cohort of migraine symptoms could be absent and children could not achieve all clinical features necessary for a migraine attack diagnosis according to classification criteria. Nevertheless, migraine is characterized also in childhood by a significant negative impact on the quality of life and a high risk of developing chronic and persistent headache in adulthood. Several studies have emphasized the role of different risk factors for migraine in children. Among these, obesity and overweight, particular food or the regular consumption of alcohol or caffeine, dysfunctional family situation, low level of physical activity, physical or emotional abuse, bullying by peers, unfair treatment in school, and insufficient leisure time seem to be strictly related to migraine onset or progression. Consequently, both identification and avoidance of triggers seem to be mandatory in children with migraine and could represent an alternative approach to the treatment of migraine abstaining from pharmacologic therapies.
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Affiliation(s)
- Antonio Russo
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy.,MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy.,Institute for Diagnosis and Care "Hermitage Capodimonte", Naples, Italy
| | - Antonio Bruno
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy
| | - Francesca Trojsi
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy.,MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Alessandro Tessitore
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy.,MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Gioacchino Tedeschi
- Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University of Naples, Naples, 80138, Italy. .,MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy. .,Institute for Diagnosis and Care "Hermitage Capodimonte", Naples, Italy.
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Glozah FN, Pevalin DJ. Association between psychosomatic health symptoms and common mental illness in Ghanaian adolescents: Age and gender as potential moderators. J Health Psychol 2016; 22:1376-1386. [PMID: 26903075 DOI: 10.1177/1359105316628736] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Little is known about the role of age and gender in the association between psychosomatic symptoms and common mental illness in Ghanaian adolescents. This cross-sectional study examined age and gender as moderators between psychosomatic symptoms and common mental illness using data from a school-based survey ( N = 770). Males reported higher psychosomatic symptoms and common mental illness, while younger adolescents reported higher common mental illness only. Psychosomatic symptoms were positively associated with common mental illness, but age and gender did not moderate this association. Interventions aimed at reducing the prevalence rate in psychosomatic symptoms are crucial in decreasing common mental illness in Ghanaian adolescents.
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Affiliation(s)
- Franklin N Glozah
- 1 Regent University College of Science and Technology, Ghana.,2 University of Essex, UK
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Hartberg S, Clench-Aas J, Raanaas RK, Lundqvist C. Coping strategies among adolescents with chronic headache and mental health problems: a cross-sectional population-based study. SPRINGERPLUS 2015; 4:801. [PMID: 26702390 PMCID: PMC4688278 DOI: 10.1186/s40064-015-1599-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 12/08/2015] [Indexed: 12/05/2022]
Abstract
To examine prevalence of mental health problems among adolescents with chronic headache and compare internal and external coping strategies in young people with chronic headaches with and without mental health problems. This study is based on a cross-sectional survey undertaken in Akershus County in Norway. A total of 19,985 adolescents were included in the study, covering lower secondary and upper secondary students, aged 13-19 years. Chronic headache was measured with a single item question based on headache frequency. Mental health was assessed by using the strengths and difficulties questionnaire (SDQ). Internal and external coping strategies were assessed through seven options for answering the question: What do you do/what happens when you are burdened by painful thoughts and feelings? Adolescents with chronic headaches showed more frequent mental health problems overall (23 %) compared to those without chronic headache (6 %). Logistic regression analyses showed that those adolescents having both chronic headaches and comorbid mental health problems more frequently used internal coping strategies, such as keeping feelings inside (OR 2.05), using abusive substances (OR 1.79) and talking oneself out of problems (OR 1.55), compared to those without mental health problems. Groups with mental health problems, especially with chronic headache, less frequently used the external strategy of talking to others about their problem than controls (OR 0.7-0.8). Factor analyses revealed significant differences in profiles of coping strategies between groups. We suggest that attention should be paid towards the high risk group that has both chronic headaches and mental health problems and their tendency to use destructive internal coping strategies.
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Affiliation(s)
- Silje Hartberg
- />Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Aas, Norway
- />Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway
| | - Jocelyne Clench-Aas
- />Division of Mental Health, Department of Health Surveillance and Prevention, Norwegian Institute of Public Health, Oslo, Norway
| | - Ruth Kjærsti Raanaas
- />Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Aas, Norway
| | - Christofer Lundqvist
- />Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway
- />Department of Neurology, Akershus University Hospital, Lørenskog, Norway
- />Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway
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Kaczynski K, Gambhir R, Caruso A, Lebel A. Depression as a mediator of the relation between family functioning and functional disability in youth with chronic headaches. Headache 2015; 56:491-500. [DOI: 10.1111/head.12709] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Karen Kaczynski
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine; Children's Hospital Boston and Harvard Medical School; Boston MA USA
- Department of Psychiatry; Children's Hospital Boston and Harvard Medical School; Boston MA USA
| | - Rupa Gambhir
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine; Children's Hospital Boston and Harvard Medical School; Boston MA USA
- Department of Psychiatry; Children's Hospital Boston and Harvard Medical School; Boston MA USA
| | - Alessandra Caruso
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine; Children's Hospital Boston and Harvard Medical School; Boston MA USA
| | - Alyssa Lebel
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine; Children's Hospital Boston and Harvard Medical School; Boston MA USA
- Department of Neurology; Children's Hospital Boston and Harvard Medical School; Boston MA USA
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Law EF, Beals-Erickson SE, Noel M, Claar R, Palermo TM. Pilot Randomized Controlled Trial of Internet-Delivered Cognitive-Behavioral Treatment for Pediatric Headache. Headache 2015; 55:1410-25. [PMID: 26316194 DOI: 10.1111/head.12635] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To evaluate the feasibility and preliminary effectiveness of an Internet-delivered cognitive-behavioral therapy (CBT) intervention for adolescents with chronic headache. BACKGROUND Headache is among the most common pain complaints of childhood. Cognitive-behavioral interventions are efficacious for improving pain among youth with headache. However, many youth do not receive psychological treatment for headache due to poor access, which has led to consideration of alternative delivery modalities such as the Internet. METHODS We used a parallel arm randomized controlled trial design to evaluate the feasibility and preliminary effectiveness of an Internet-delivered family-based CBT intervention, Web-based management of adolescent pain. Adolescents were eligible for the trial if they were a new patient being evaluated in a specialized headache clinic, between 11 and 17 years of age, and had recurrent headache for 3 months or more as diagnosed by a pediatric neurologist. Eighty-three youths were enrolled in the trial. An online random number generator was used to randomly assign participants to receive Internet CBT adjunctive to specialized headache treatment (n = 44) or specialized headache treatment alone (n = 39). The primary treatment outcome was headache days. RESULTS Youth and parents in the Internet CBT group demonstrated high levels of engagement with the web program and reported satisfaction with the intervention. Multilevel modelling (MLM) was used to conduct hypothesis testing for continuous outcomes. For our primary treatment outcome of headache days, adolescents reported a statistically significant reduction in headache days from baseline to post-treatment and baseline to 3-month follow-up in both treatment conditions (main effect for time F(2, 136) = 19.70, P < .001). However, there was no statistically significant difference between the Internet CBT group and the specialized headache treatment group at post-treatment or follow-up (group × time interaction F(2, 134) = 0.94, P = .395). For our secondary treatment outcomes, findings from MLM showed that adolescents in both groups demonstrated statistically significant improvement headache pain intensity, activity limitations, depressive symptoms, and parent protective behaviors from baseline to post-treatment and these gains were maintained at 3-month follow-up. Adolescent anxiety symptoms and sleep did not change during the study period for either group. There were no statistically significant group differences on any secondary outcomes at post-treatment or follow-up (P > .05 for all outcomes). No adverse events were reported. CONCLUSION Although adjunctive Internet CBT did not lead to additional benefit in this population, future research should evaluate whether it is an effective intervention for adolescents with headache who are unable to access specialized headache treatment.
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Affiliation(s)
- Emily F Law
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, USA.,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, USA
| | - Sarah E Beals-Erickson
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, USA
| | - Melanie Noel
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, USA
| | - Robyn Claar
- Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School and Boston Children's Hospital, Boston, USA
| | - Tonya M Palermo
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, USA.,Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, USA
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Tarantino S, De Ranieri C, Dionisi C, Gagliardi V, Capuano A, Vigevano F, Gentile S, Valeriani M. Migraine equivalents and related symptoms, psychological profile and headache features: which relationship? J Headache Pain 2015; 16:536. [PMID: 26059348 PMCID: PMC4467804 DOI: 10.1186/s10194-015-0536-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/01/2015] [Indexed: 01/03/2023] Open
Abstract
Background Migraine equivalents are common clinical conditions in children suffering from headache. Very few studies dealt with the psychological profile of children/adolescents with migraine equivalents. Our main aim was to compare the psychological profile between migraine children with and without migraine equivalents. Moreover, as secondary aim, exclusively in children with migraine equivalents, we investigated the possible relationship between migraine attack frequency and intensity and psychological factors. Methods We enrolled 136 young migraineurs. They were divided in two groups (patients with and without migraine equivalents). The psychological profile was assessed by means of SAFA Anxiety and Somatization questionnaires. Results Migraine equivalents were present in 101 patients (74.3 %). Anxiety (p = 0.024) and somatization (p = 0.001) levels, but not hypochondria (p = 0.26), were higher in patients with migraine equivalents. In children with migraine equivalents, a low frequency of attacks was related to separation anxiety (p = 0.034). Conclusions Migraine equivalents patients tend to feel more fearful and to experience more shyness. This, together with the tendency to somatization, may lead them to become vigilant in attachment relationships with their caregivers.
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Affiliation(s)
- Samuela Tarantino
- Headache Center, Division of Neurology, Ospedale Pediatrico Bambino Gesú, IRCCS, Piazza Sant'Onofrio 4, 00165, Rome, Italy,
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Tran ST, Jastrowski Mano KE, Hainsworth KR, Medrano GR, Anderson Khan K, Weisman SJ, Davies WH. Distinct Influences of Anxiety and Pain Catastrophizing on Functional Outcomes in Children and Adolescents With Chronic Pain. J Pediatr Psychol 2015; 40:744-55. [DOI: 10.1093/jpepsy/jsv029] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 03/11/2015] [Indexed: 11/13/2022] Open
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Blaauw BA, Dyb G, Hagen K, Holmen TL, Linde M, Wentzel-Larsen T, Zwart JA. The relationship of anxiety, depression and behavioral problems with recurrent headache in late adolescence – a Young-HUNT follow-up study. J Headache Pain 2015; 16:10. [PMID: 25595046 PMCID: PMC4405520 DOI: 10.1186/1129-2377-16-10] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 12/22/2014] [Indexed: 11/25/2022] Open
Abstract
Background The comorbidity of headache and psychiatric symptoms is a well-recognized clinical phenomenon, but there are only limited data regarding the temporal relationship between headache and symptoms of anxiety and depression as well as behavioral problems in adolescents. This study investigates the relationship of anxiety and depressive symptoms and behavioral problems at baseline with recurrent headache at follow-up four years later. Methods Within the Nord-Trøndelag Health Study (HUNT), including repeated population-based studies conducted in Norway, 2399 adolescents in junior high schools aged 12–16 years (77% of the invited) participated in Young-HUNT1 (1995–1997) and again at follow-up four years later, in Young-HUNT2 (2000–2001). The same comprehensive questionnaire that included assessment of symptoms of anxiety and depression and behavioral problems, i.e. conduct and attention difficulties was completed in both studies. In addition 1665 of the participants were interviewed about their headache complaints in Young-HUNT2. Results In adjusted multivariate analyses we found that higher scores of anxiety and depressive symptoms at baseline were associated with recurrent headache at follow-up four years later (OR: 1.6, 95% CI: 1.2-2.1, p = 0.001), evident for migraine (OR: 1.8, 95% CI: 1.2-2.7, p = 0.008) and non-classifiable headache (OR: 1.7, 95% CI: 1.0-2.8, p = 0.034), but not statistically significant for tension-type headache (OR: 1.4, 95% CI: 1.0-1.9, p = 0.053). Higher scores of anxiety and depressive symptoms at baseline were significantly associated with more frequent headache at follow-up (monthly vs. no recurrent headache OR: 1.8, 95% CI: 1.3-2.5, p = 0.001, weekly or daily vs. no recurrent headache OR: 1.9, 95% CI: 1.2-2.9, p = 0.005). Among adolescents without recurrent headache at baseline, higher scores for symptoms of anxiety and depression were associated with new onset migraine four years later (OR: 2.6, 95% CI: 1.1-4.8, p = 0.036). Higher scores of attention problems at baseline were associated with non-classifiable headache at follow-up (OR: 2.0, 95% CI: 1.3-3.4, p = 0.017). Conclusions Results from the present study showed that symptoms of anxiety and depression in early adolescence were associated with recurrent headache four years later. Recognizing anxiety and depressive symptoms should be considered part of the clinical assessment in young headache patients, as early identification of these associated factors may lead to improved headache management.
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Affiliation(s)
- Brit A Blaauw
- Department of Neurology, Vestfold Hospital, Tønsberg, Norway.
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Bektaş Ö, Uğur C, Gençtürk ZB, Aysev A, Sireli Ö, Deda G. Relationship of childhood headaches with preferences in leisure time activities, depression, anxiety and eating habits: A population-based, cross-sectional study. Cephalalgia 2014; 35:527-37. [PMID: 25149505 DOI: 10.1177/0333102414547134] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 07/06/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The objective of this article is to determine the relationship between headache frequency and socio-demographic data, personal characteristics, habits, daily activities, daily loss of ability, depression and anxiety in the headache subtypes in the pediatric population. PATIENTS AND METHODS Our sample group was composed of approximately 5355 children aged between 9 and 18 years. An eight-stage questionnaire was administered to the children. In the second stage of the study, headache subtypes were created according to the ICHD-II criteria. The resulting data were compared according to the results of the headache subtypes. RESULTS In school-age children, the prevalence of recurrent headaches was 39.4%, and the prevalence of migraine was 10.3%. The subjects with migraine mostly preferred sedentary activities in their leisure time, and preferred less exercise than the subjects with the other headache types. The PedMIDAS score of the children who preferred to play sports was significantly lower than those who did not prefer to play sports. In the group that preferred reading books, an opposite relationship was found. In overweight and obese migraine sufferers, other types of headache were found to be significantly higher. CONCLUSIONS In the management of treating childhood headaches, the association of psychiatric comorbidities should be considered. To minimize disability, children should be directed to more useful physical activities.
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Affiliation(s)
- Ömer Bektaş
- Department of Pediatric Neurology, Ankara University Medical School, Turkey
| | - Cağatay Uğur
- Department of Child and Adolescent Psychiatry, Ankara University Medical School, Turkey
| | | | - Ayla Aysev
- Department of Child and Adolescent Psychiatry, Ankara University Medical School, Turkey
| | - Özlem Sireli
- Department of Child and Adolescent Psychiatry, Ankara University Medical School, Turkey
| | - Gülhis Deda
- Department of Pediatric Neurology, Ankara University Medical School, Turkey
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Gobina I, Villberg J, Villerusa A, Välimaa R, Tynjälä J, Ottova-Jordan V, Ravens-Sieberer U, Levin K, Cavallo F, Borraccino A, Sigmund E, Andersen A, Holstein BE. Self-reported recurrent pain and medicine use behaviours among 15-year olds: results from the international study. Eur J Pain 2014; 19:77-84. [PMID: 24807819 DOI: 10.1002/ejp.524] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND There is considerable variation in adolescent pain prevalence across epidemiological studies, with limited information on pain-related behaviours among adolescents, including medicine use. The aims of this study were (1) to examine the prevalence of recurrent pain among 15-year-old adolescents internationally; (2) to investigate the association between recurrent pain and medicine use behaviours among boys and girls; and (3) to evaluate the consistency of these associations across countries. METHODS The World Health Organization (WHO) collaborative international Health Behaviour in School-aged Children 2009/2010 study collects data about self-reported aches and medicine use from 36,762 15-year-old adolescents from 22 countries/regions in Europe and the United States. Multi-level multivariate logistic regression, stratified by gender, was used to analyse the association between recurrent pain and medicine use for headache, stomachache, nervousness and difficulties in getting to sleep. RESULTS More than 30% of adolescents reported recurrent headache, almost 30% recurrent backache and approximately 20% recurrent stomachache. Although pain prevalence and medicine use for aches were much higher for girls, the association between pain and medicine use was similarly strong for both genders. Adolescents with recurrent pain are more likely to use medicines also for non-corresponding pain, nervousness and difficulties in getting to sleep. The association between recurrent pain and medicine use was consistent across countries despite large-country differences in the prevalence of recurrent pain and medicine use. CONCLUSIONS Recurrent pain in adolescence is common cross-nationally. Adolescents with recurrent pain are more likely to use medicine in general. Recurrent pain and medicine use should be addressed in adolescent health policies.
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Affiliation(s)
- I Gobina
- Department of Public Health and Epidemiology, Riga Stradins University, Latvia
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Powers SW. Logan Wright Award: Team science, team care, team training, and team leadership: my experience. J Pediatr Psychol 2014; 39:277-82. [PMID: 24648410 DOI: 10.1093/jpepsy/jsu002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Scott W Powers
- PhD, FAHS, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, ML-3015, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
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Karlson CW, Litzenburg CC, Sampilo ML, Rapoff MA, Connelly M, Bickel JL, Hershey AD, Powers SW. Relationship between daily mood and migraine in children. Headache 2013; 53:1624-34. [PMID: 24102349 DOI: 10.1111/head.12215] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Retrospective and cross-sectional studies have suggested a bidirectional relationship between migraine and mood disturbance. OBJECTIVE The present prospective daily diary study examined the prevalence and temporal associations between migraine and daily mood, mood and next-day headache, and headache and next-day mood. METHODS Sixty-nine children (50 females, 19 males) between the ages of 7 and 12 years and their parents attending neurology clinic appointments and having a diagnosis of migraine as defined by International Headache Classification 2nd edition criteria completed measures on the quality of life, headache disability, child emotions, and child behaviors. Children and parents then recorded children's headache occurrence, headache duration, headache severity, mood, daily hassles, and medication use on paper diaries once a day for 2 consecutive weeks. "Mood" was defined using the Facial Affective Scale, which is a visual representation of negative and positive affect. Data were analyzed using multilevel models. RESULTS Controlling for age, sex, quality of life, headache disability, and medication use, worse mood was associated with same-day occurrence, longer duration, and more severe headache in both child and parent report. Today's mood was not consistently associated with next-day headache, and today's headache was not associated with next-day mood in either child or parent report. CONCLUSIONS Results of this study lend support to a complex relationship between mood and headache in children with migraine. More research is needed to further elucidate the temporal nature of this relationship within a given day and over an extended period of time.
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Affiliation(s)
- Cynthia W Karlson
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, USA
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Iacovelli E, Tarantino S, Capuano A, De Luca M, De Ranieri C, Vigevano F, Arendt-Nielsen L, Valeriani M. Different SEP recovery cycle in adolescent migraineurs with exploding or imploding pain. Neurosci Res 2013; 77:78-86. [DOI: 10.1016/j.neures.2013.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Revised: 04/21/2013] [Accepted: 06/26/2013] [Indexed: 11/16/2022]
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Kröner-Herwig B, Maas J. The German Pain Catastrophizing Scale for Children (PCS-C) - psychometric analysis and evaluation of the construct. PSYCHO-SOCIAL MEDICINE 2013; 10:Doc07. [PMID: 23922617 PMCID: PMC3734764 DOI: 10.3205/psm000097] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective: The Pain Catastrophizing Scale, adapted for children (PCS-C) by Crombez et al. (2003), was translated into German (SKS-D) and evaluated regarding its factorial structure, its reliability and validity. The association of catastrophizing with various pain characteristics and disability measures was examined as well as its association to neighboring constructs. Method: The paper-and-pencil version of the SKS-D was used in two different samples of children and adolescents. Analyses were conducted on a subgroup of participants from an epidemiological sample [n=898; age: M=12.9 (SD=1.4)] who had experienced monthly headaches in the 6-months period before and a clinical sample [n=60; age: M=12.6 (SD=0.8)] seeking treatment for recurrent headaches. Results: Exploratory factor analysis (PCA) suggested a one-factor model in contrast to the 3-factor model suggested by Crombez et al. (2003). The unidimensional scale showed distinct homogeneity and satisfying reliability. The clinical sample showed significantly higher scores than the epidemiological group. Also girls scored higher than boys. The catastrophizing explained a considerable amount of variance in pain and disability parameters in both samples thus underlining its validity. The psychological variables internalising, anxiety sensitivity and somatosensory amplification showed significant small to moderate associations with pain catastrophizing and also with pain and disability. After controlling for the above mentioned psychological variables, catastrophizing still yielded an independent contribution to the explanation of variance in pain and disability parameters. Conclusions: The PCS-C in its German form is a valid and reliable instrument for assessing catastrophizing in children with recurrent pain, in particular headache, in the age of 10–16 years. Pain catastrophizing is suggested to be assessed especially in pediatric pain patients as it is a significant moderator of pain and disability. In children with a distinct tendency to catastrophize cognitive restructuring should become a target of pediatric pain therapy, as a reduction of catastrophizing cognitions may indirectly help to ameliorate pain and disability.
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Affiliation(s)
- Birgit Kröner-Herwig
- Georg-Elias-Müller-Institute, University of Göttingen, Dept. of Clinical Psychology and Psychotherapy, Göttingen, Germany
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Efficacy of psychological treatment for headaches: an overview of systematic reviews and analysis of potential modifiers of treatment efficacy. Clin J Pain 2013; 30:353-69. [PMID: 23823250 DOI: 10.1097/ajp.0b013e318298dd8b] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES A variety of psychological treatments exist for headaches (HAs). Their efficacy has been evaluated through systematic reviews with meta-analysis. Our goal was to evaluate the scope of these reviews and reevaluate the efficacy of treatments considering potential sources of variation systematically. These findings should help guide clinical practice and will provide guidance to researchers planning to address the efficacy of psychological treatments for HAs. MATERIALS AND METHODS Two systematic reviews were conducted: one searched for systematic reviews with meta-analysis exploring the efficacy of psychological treatments for HA in Cochrane Database, DARE, EMBASE, ISI Web of Knowledge, Medline, and PsychINFO from inception to December 2011. Two independent reviewers screened, evaluated quality, and extracted data. The second review searched for primary studies from the included reviews estimating the efficacy of psychological treatments for a clinically significant change. RESULTS Eighteen reviews met a priori criteria for inclusion. The broad scope of research on efficacy of psychological treatments for HA is reflected by variation in clinical and methodological characteristics of the reviews. These variations were explored through meta-analysis and subgroup analysis of 41 primary studies and showed that some of these variations, including time of assessment, treatment type, age, HA diagnosis, and study quality, can impact the magnitude of treatment effect. DISCUSSION There is substantial evidence in favor of psychological treatments for HA management. Further investigation, especially in specific treatments (cognitive-behavioral or autogenic treatment) for HA disorders, is needed. The assessment of these systematic reviews highlighted key areas where improvement should be made to increase the quality of evidence.
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Claar RL, Kaczynski KJ, Minster A, McDonald-Nolan L, LeBel AA. School functioning and chronic tension headaches in adolescents: improvement only after multidisciplinary evaluation. J Child Neurol 2013; 28:719-24. [PMID: 22805252 DOI: 10.1177/0883073812450945] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pediatric patients with chronic tension-type headaches often experience significant school impairment. Although some improve after treatment with a neurologist, many require more comprehensive treatment. The authors examined whether school functioning and attendance improved after a multidisciplinary evaluation focusing on a return to functioning despite headaches. They also examined whether patients' headaches improved. Participants were 47 adolescents ages 12-17, most of whom had not responded to past neurological treatment. Adolescents completed the PedsQL School Functioning Scale at evaluation, 2-3 months later, and again 6 months after evaluation. Information regarding headache frequency, severity and duration, and school attendance was obtained from medical records. Using repeated measures analyses of variance, the authors found that school functioning and attendance improved significantly from evaluation to follow-up, as did headache frequency and duration. An emphasis on returning to functioning can help patients with chronic, difficult-to-treat tension-type headaches improve in their school functioning and experience fewer, shorter headaches.
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Affiliation(s)
- Robyn Lewis Claar
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston and Harvard Medical School, 333 Longwood Ave, Boston, MA 02115, USA.
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