Article

Psychopathology in children and adolescents with primary headaches: Categorical and dimensional approaches

Psychiatry Unit, Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neurosciences and Sense Organs of the "Aldo Moro" University of Bari, Italy.
Cephalalgia (Impact Factor: 4.12). 07/2013; 33(16). DOI: 10.1177/0333102413495966
Source: PubMed

ABSTRACT Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children.
The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment.
The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments.
Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders.
The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research.

0 Followers
 · 
77 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Primary headaches among children and adolescents have a substantial impact on quality of life, daily activities, social interaction, and school performance in combination with psychopathological symptoms. The main purpose of the present paper is to summarize clinical and epidemiological evidence for psychiatric comorbidity among children and adolescents with headaches, to describe how evidence in headache research suggest different pathways involved in the development and maintenance of these comorbid conditions, and finally suggest some elements professionals may find helpful to assess the scope of complaints, related functional impairment, and potential precipitating factors in planning of more targeted treatments.
    Current Pain and Headache Reports 04/2015; 19(4):479. DOI:10.1007/s11916-015-0479-y · 2.26 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Migraine is a common disorder and a frequent cause of medical consultation in children. Many childhood episodic syndromes have been described as common precursors of migraine. To review current knowledge on migraine and childhood episodic syndromes, and to discuss future directions for research and clinical practice. For most children it is difficult to describe a headache and fully verbalize symptoms such as photophobia and phonophobia that must be inferred from behaviour. Classical migraine features are rare before the age of 6 years, but some migraine-related syndromes have been described. Benign paroxysmal torticollis of infancy, benign paroxysmal vertigo of childhood, cyclic vomiting syndrome and abdominal migraine are currently classified as childhood episodic syndromes, and therefore common precursors of migraine. A strong association between infantile colic and migraine has recently been reported. There are similarities between children with episodic syndromes and children with migraine, regarding social and demographic factors, precipitating and relieving factors, and accompanying gastrointestinal, neurologic, and vasomotor features. The real pathophysiological mechanisms of migraine are not fully understood. Current data obtained through molecular and functional studies provide a complex model in which vascular and neurologic events cooperate in the pathogenesis of migraine attacks. Genetic factors causing disturbances in neuronal ion channels, make a migraineur more sensitive to multiple trigger factors that activate the nociception cascade. The expanding knowledge on migraine genetics and pathophysiology may be applicable to childhood episodic syndromes. Migraine preventive strategies are particularly important in children, and could be beneficial in childhood episodic syndromes. Nonspecific analgesics like ibuprofen and acetaminophen are widely used in pediatrics to control pain and have been found to be effective also in the treatment of acute migraine attacks. Triptans are the specific fist-line drugs for acute migraine treatment. Migraine phenotype differs somewhat in the developing brain, and childhood episodic syndromes may arise before typical migraine headache. Diagnosing pediatric migraine may be difficult because of children's language and cognitive abilities. The risk of underestimating migraine in pediatric age is high. An adequate diagnosis is important to maintain a good quality of life and to avoid inappropriate therapy.
    Italian Journal of Pediatrics 12/2014; 40 Suppl 1(1):92. DOI:10.1186/s13052-014-0092-4
  • [Show abstract] [Hide abstract]
    ABSTRACT: Headaches that last less than one hour in duration are uncommon, except for atypical migraine, and, without a practitioner's appropriate knowledge, may result in misdiagnosis. Although most of these headaches are classified as primary headache syndromes, some have secondary etiologies such as structural lesions. This pediatric-specific review updates these headache syndromes. Discussed are atypical migraine, the trigeminal autonomic cephalgias (TAC), cranial neuralgias, occipital neuralgia, thunderclap headache, nummular headache, the red ear syndrome and the numbtongue syndrome.
    Pediatric Neurology 10/2014; 52(2). DOI:10.1016/j.pediatrneurol.2014.10.018 · 1.50 Impact Factor

Full-text

Download
2 Downloads
Available from
Mar 11, 2015