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Al-Beltagi M, Saeed NK, Bediwy AS, Elbeltagi R. Breaking the cycle: Psychological and social dimensions of pediatric functional gastrointestinal disorders. World J Clin Pediatr 2025; 14:103323. [DOI: 10.5409/wjcp.v14.i2.103323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 12/14/2024] [Accepted: 01/02/2025] [Indexed: 03/18/2025] Open
Abstract
BACKGROUND Functional gastrointestinal disorders (FGIDs) in children present with chronic symptoms like abdominal pain, diarrhea, and constipation without identifiable structural abnormalities. These disorders are closely linked to gut-brain axis dysfunction, altered gut microbiota, and psychosocial stress, leading to psychiatric comorbidities such as anxiety, depression, and behavioral issues. Understanding this bidirectional relationship is crucial for developing effective, holistic management strategies that address physical and mental health.
AIM To examine the psychiatric impacts of FGIDs in children, focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood, such as attention-deficit/hyperactivity disorder, emphasizing the role of the gut-brain axis, emotional dysregulation, and psychosocial stress. Key mechanisms explored include neurotransmitter dysregulation, microbiota imbalance, central sensitization, heightening stress reactivity, emotional dysregulation, and symptom perception. The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.
METHODS A narrative review was conducted using 328 studies sourced from PubMed, Scopus, and Google Scholar, covering research published over the past 20 years. Inclusion criteria focused on studies examining FGID diagnosis, gut-brain mechanisms, psychiatric comorbidities, and psychosocial factors in pediatric populations. FGIDs commonly affecting children, including functional constipation, abdominal pain, irritable bowel syndrome, gastroesophageal reflux, and cyclic vomiting syndrome, were analyzed concerning their psychological impacts.
RESULTS The review highlights a strong connection between FGIDs and psychiatric symptoms, mediated by gut-brain axis dysfunction, dysregulated microbiota, and central sensitization. These physiological disruptions increase children’s vulnerability to anxiety and depression, while psychosocial factors - such as chronic stress, early-life trauma, maladaptive family dynamics, and ineffective coping strategies - intensify the cycle of gastrointestinal and emotional distress.
CONCLUSION Effective management of FGIDs requires a biopsychosocial approach integrating medical, psychological, and dietary interventions. Parental education, early intervention, and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.
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Affiliation(s)
- Mohammed Al-Beltagi
- Department of Paediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
- Department of Pediatric, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Nermin K Saeed
- Medical Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Governmental Hospitals, Manama 26671, Bahrain
- Medical Microbiology Section, Department of Pathology, The Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Muharraq, Bahrain
| | - Adel S Bediwy
- Department of Pulmonology, Faculty of Medicine, Tanta University, Tanta 31527, Alghrabia, Egypt
- Department of Pulmonology, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Bahrain
| | - Reem Elbeltagi
- Department of Medicine, Royal College of Surgeons in Ireland - Bahrain, Busaiteen 15503, Muharraq, Bahrain
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Li X, Luo S, Lin L, Li C, Li J, Cao W, Chen W, Ren Y, Zhang M, Zhang C, Guo VY. Association between family disharmony, maternal negative emotional states, and behavioral problems among Chinese children attending preschools. J Affect Disord 2025; 377:217-224. [PMID: 39986579 DOI: 10.1016/j.jad.2025.02.057] [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: 02/20/2024] [Revised: 02/10/2025] [Accepted: 02/17/2025] [Indexed: 02/24/2025]
Abstract
BACKGROUND Although previous studies have shown that children from disharmonious families were more likely to exhibit behavioral problems, the underlying pathways remain unclear. This study aimed to assess the associations between family disharmony and behavioral problems among Chinese preschool children and to investigate the potential mediating role of maternal negative emotional states. METHODS A cross-sectional study including 4243 preschool children and their mothers was conducted in Chengdu, China. Mothers reported the level of family disharmony and their negative emotional states, including depression, anxiety, and stress. They also reported their children's behavioral problems using the Conners' Parent Rating Scale-48 items. Generalized structural equation models and bootstrapping methods were used to explore the mediating role of maternal negative emotional states in the associations between family disharmony and children's behavioral problems. RESULTS Preschool children from disharmonious families had a significantly higher prevalence of behavioral problems. Family disharmony was positively associated with various behavioral problems across multiple domains. In addition, maternal negative emotional states partially mediated these associations, with mediation proportions ranging from 49.63 % for anxiety to 63.96 % for impulsive-hyperactive. LIMITATIONS The cross-sectional design limited causal inferences. CONCLUSION Our study highlighted the significant impact of family disharmony on preschool children's behavioral problems and confirmed the mediating role of maternal negative emotional states. The findings suggested that implementing interventions aimed at improving family harmony and addressing maternal negative emotions may effectively reduce the risk of behavioral problems among Chinese preschool children. Nevertheless, future randomized controlled trials are needed to confirm the conclusions.
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Affiliation(s)
- Xinger Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou, China
| | - Shengyu Luo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou, China
| | - Li Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou, China
| | - Chunrong Li
- Chengdu Jintang County Maternal and Child Health Hospital, Chengdu, Sichuan, China; Chengdu Xinjin District Maternal and Child Health Care Hospital, Chengdu, Sichuan, China.
| | - Jinghua Li
- Department of Biostatistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou, Guangdong, China
| | - Wangnan Cao
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou, China
| | - Yan Ren
- School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Meng Zhang
- School of Medicine, Chengdu Women's and Children's Central Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Cheng Zhang
- Chengdu Xinjin District Maternal and Child Health Care Hospital, Chengdu, Sichuan, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Second Road, Guangzhou, China.
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Khan A, Liu S, Tao F. Current Trends in Pediatric Migraine: Clinical Insights and Therapeutic Strategies. Brain Sci 2025; 15:280. [PMID: 40149800 DOI: 10.3390/brainsci15030280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Revised: 02/28/2025] [Accepted: 03/04/2025] [Indexed: 03/29/2025] Open
Abstract
Background/Objectives: Pediatric migraine is a prevalent neurological disorder that significantly impacts children's quality of life, academic performance, and social interactions. Unlike migraines in adults, pediatric migraines often present differently and involve unique underlying mechanisms, making diagnosis and treatment more complex. Methods: This review discusses the clinical phases of pediatric migraine, key trigger factors, sex- and age-related differences, and the role of childhood maltreatment in migraine development. We also discuss episodic syndromes such as cyclic vomiting syndrome, abdominal migraine, benign paroxysmal vertigo, and benign paroxysmal torticollis, along with comorbidities such as psychiatric disorders, sleep disturbances, and epilepsy. Results: The underlying pathophysiological mechanisms for pediatric migraines, including genetic predispositions, neuroinflammation, and gut microbiota dysbiosis, are summarized. Current therapeutic strategies, including conventional and emerging pharmacological treatments, nutraceuticals, and non-pharmacological approaches, are evaluated. Non-pharmacological strategies, particularly evidence-based lifestyle interventions such as stress management, diet, hydration, sleep, exercise, screen time moderation, and cognitive behavioral therapy, are highlighted as key components of migraine prevention and management. The long-term prognosis and follow-up of pediatric migraine patients are reviewed, emphasizing the importance of early diagnosis, and tailored multidisciplinary care to prevent chronic progression. Conclusions: Future research should focus on novel therapeutic targets and integrating gut-brain axis modulation, with a need for longitudinal studies to better understand the long-term course of pediatric migraine.
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Affiliation(s)
- Adnan Khan
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, 3302 Gaston Ave., Dallas, TX 75246, USA
| | - Sufang Liu
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, 3302 Gaston Ave., Dallas, TX 75246, USA
| | - Feng Tao
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, 3302 Gaston Ave., Dallas, TX 75246, USA
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Pratile DC, Orlandi M, Carpani A, Mensi MM. Look at My Body: It Tells of Suffering-Understanding Psychiatric Pathology in Patients Who Suffer from Headaches, Restrictive Eating Disorders, or Non-Suicidal Self-Injuries (NSSIs). Pediatr Rep 2025; 17:21. [PMID: 39997628 PMCID: PMC11858191 DOI: 10.3390/pediatric17010021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2024] [Revised: 01/29/2025] [Accepted: 02/06/2025] [Indexed: 02/26/2025] Open
Abstract
Background/Objectives: Adolescence is a developmental stage characterized by profound physical and psychological transformations, often leading to vulnerabilities such as body dissatisfaction, identity challenges, and the use of maladaptive coping strategies. This often leads to body-related psychopathologies, including headaches, restrictive eating disorders, and non-suicidal self-injury (NSSI). The present study aimed to describe the typical functioning and features of these conditions and the differences between the three groups, and to identify the most effective assessment for predicting these conditions. Methods: Sixty adolescent patients (51 female; mean age = 15.34 ± 1.80) were divided into three groups: headaches, restrictive eating disorders, and NSSI, and assessed for differences in symptoms, cognitive performance, personality, functioning, and illness severity using semi-structured interviews, clinician-based scales, and performance-based tests like the Rorschach inkblot test, according to the Rorschach Performance Assessment System (R-PAS). Results: Individuals with headaches experienced more internalizing symptoms, had an average IQ, maintained some functioning areas, and had distorted patterns of self-other relationships with the tendency to project malevolent aspects onto others. Patients with restrictive eating disorders had high levels of depressive symptoms, above-average IQ scores, negative symptoms, moderate presence of obsessive-compulsive personality traits, disorganized thinking, and a tendency to interpret situations subjectively. Patients with NSSI showed the highest level of depressive symptoms and social anxiety symptoms, and a considerable presence of psychotic symptoms and perceptual distortions. Negative symptoms, borderline personality traits, and psychosis symptoms had the strongest predictivity. Conclusions: The study provides clinicians with relevant insights into the features of these conditions and highlights assessment strategies, tailored interventions, and enhanced outcomes for these vulnerable populations.
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Affiliation(s)
- Diletta Cristina Pratile
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (D.C.P.); (M.M.M.)
| | - Marika Orlandi
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (D.C.P.); (M.M.M.)
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy
| | - Adriana Carpani
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy
| | - Martina Maria Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy; (D.C.P.); (M.M.M.)
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100 Pavia, Italy
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Crowe HM, Sampson L, Purdue-Smithe AC, Rexrode KM, Koenen KC, Rich-Edwards JW. Bidirectional analysis of the association between migraine and post-traumatic stress disorder in Nurses' Health Study II. Epidemiol Psychiatr Sci 2024; 33:e76. [PMID: 39658814 DOI: 10.1017/s2045796024000799] [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] [Indexed: 12/12/2024] Open
Abstract
AIMS Migraine and post-traumatic stress disorder (PTSD) are both twice as common in women as men. Cross-sectional studies have shown associations between migraine and several psychiatric conditions, including PTSD. PTSD is disproportionally common among patients in headache clinics, and individuals with migraine and PTSD report greater disability from migraines and more frequent medication use. To further clarify the nature of the relationship between PTSD and migraine, we conducted bidirectional analyses of the association between (1) migraine and incident PTSD and (2) PTSD and incident migraine. METHODS We used longitudinal data from 1989-2020 among the 33,327 Nurses' Health Study II respondents to the 2018 stress questionnaire. We used log-binomial models to estimate the relative risk of developing PTSD among women with migraine and the relative risk of developing migraine among individuals with PTSD, trauma-exposed individuals without PTSD, and individuals unexposed to trauma, adjusting for race, education, marital status, high blood pressure, high cholesterol, alcohol intake, smoking, and body mass index. RESULTS Overall, 48% of respondents reported ever experiencing migraine, 82% reported experiencing trauma and 9% met the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for PTSD. Of those reporting migraine and trauma, 67% reported trauma before migraine onset, 2% reported trauma and migraine onset in the same year and 31% reported trauma after migraine onset. We found that migraine was associated with incident PTSD (adjusted relative risk [RR]: 1.26, 95% confidence interval [CI]: 1.14-1.39). PTSD, but not trauma without PTSD, was associated with incident migraine (adjusted RR: 1.20, 95% CI: 1.14-1.27). Findings were consistently stronger in both directions among those experiencing migraine with aura. CONCLUSIONS Our study provides further evidence that migraine and PTSD are strongly comorbid and found associations of similar magnitude between migraine and incident PTSD and PTSD and incident migraine.
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Affiliation(s)
- H M Crowe
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - L Sampson
- Program in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook, NY, USA
| | - A C Purdue-Smithe
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - K M Rexrode
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
| | - K C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - J W Rich-Edwards
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Yu X, Tan G. Role of Psychological Factors in Migraine. Cureus 2024; 16:e75858. [PMID: 39822418 PMCID: PMC11736672 DOI: 10.7759/cureus.75858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2024] [Indexed: 01/19/2025] Open
Abstract
Migraine, marked by moderate to severe headaches, is frequently accompanied by reversible neurological symptoms. Recent studies have revealed a complex and significant relationship between psychological factors and the onset and progression of migraine. Personality traits, such as neuroticism and harm avoidance, play a crucial role in the development, progression, and treatment outcomes of migraines. Migraine patients often experience comorbid mental health conditions, such as depression and anxiety, which contribute to a diminished quality of life by exacerbating migraine-related disability and impaired occupational functioning. In particular, high levels of pain catastrophizing and anxiety sensitivity in migraine sufferers reflect their negative cognitive beliefs, which are closely linked to both their personality traits and vulnerability to mental disorders. This article explores the pathophysiological mechanisms underlying the relationship between migraine and psychological factors, including genetic influences, overlapping brain regions, 5-hydroxytryptamine (5-HT) dysfunction, and neurogenic inflammation. While traditional pharmacological treatments for migraine are often influenced by psychological factors and may have limited efficacy, psychotherapy, such as cognitive behavioral therapy and positive thinking therapy, has been increasingly recognized for its role in alleviating the psychological symptoms associated with migraine and enhancing overall therapeutic outcomes.
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Affiliation(s)
- Xiran Yu
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, CHN
| | - Ge Tan
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, CHN
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Cesur E, Yavuz BG, Acar E, Özdemir Z, Soyukibar TE, Aydınlar EI. Somatic amplification and addiction profile as risk factors for medication overuse headache with chronic migraine. Neurol Sci 2024; 45:5375-5383. [PMID: 38872072 PMCID: PMC11470874 DOI: 10.1007/s10072-024-07639-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 06/07/2024] [Indexed: 06/15/2024]
Abstract
INTRODUCTION Overuse of analgesics can lead to medication-overuse headache (MOH) in chronic migraine (CM) patients, and is often linked to addiction. This study explores the addiction-related characteristics and somatic amplification in patients with, CM with medication overuse headache (CM+MOH), CM, and healthy controls. METHODS 73 CM patients and 70 CM+MOH, along with 63 healthy controls, participated in the study. Assessments included a Sociodemographic Form, Migraine Disability Assessment Scale (MIDAS), Addiction Profile Index (API), Addiction Profile Index-Clinical Version (API-C), and the Somatosensory Amplification Scale (SSAS). RESULTS Substance use characteristics, craving, motivation for use, and addiction severity scores were higher in the CM+MOH group than in both the CM and the control group. Specifically, the SSAS scores within the CM+MOH group surpassed those of both the CM and control groups. In the CM+MOH group, SSAS scores were a strong predictor of the amount of analgesic usage. Besides, craving and motivation for substance use scores significantly predicted the number of days analgesic taken per month in the CM+MOH group CONCLUSION: CM patients with MOH exhibit a pronounced association with addiction, and a heightened manifestation of somatic symptoms. Addressing addiction characteristics and psychosomatic amplification is important to ensure comprehensive management.
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Affiliation(s)
- Ender Cesur
- Department of Psychiatry, Acibadem Mehmet Ali Aydinlar University Medical Faculty, Istanbul, Türkiye
| | - Burcu Göksan Yavuz
- Department of Psychiatry, Acibadem Mehmet Ali Aydinlar University Medical Faculty, Istanbul, Türkiye.
| | - Erkan Acar
- Department of Neurology, Acibadem Mehmet Ali Aydinlar University Medical Faculty, Istanbul, Türkiye
| | - Zeynep Özdemir
- Department of Neurology, Bakirkoy Prof Mazhar Osman Training and Research Hospital, Istanbul, Türkiye
| | - Tuba Erdoğan Soyukibar
- Department of Neurology, Acibadem Mehmet Ali Aydinlar University Medical Faculty, Istanbul, Türkiye
| | - Elif Ilgaz Aydınlar
- Department of Neurology, Acibadem Mehmet Ali Aydinlar University Medical Faculty, Istanbul, Türkiye
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Lee DY, Kim C, Shin Y, Park RW. Combined Methylphenidate and Selective Serotonin Reuptake Inhibitors in Adults With Attention-Deficit/Hyperactivity Disorder. JAMA Netw Open 2024; 7:e2438398. [PMID: 39382893 PMCID: PMC11581539 DOI: 10.1001/jamanetworkopen.2024.38398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 08/16/2024] [Indexed: 10/10/2024] Open
Abstract
Importance Depression is a common comorbidity of adult attention-deficit/hyperactivity disorder (ADHD), and the combination of methylphenidate and selective serotonin reuptake inhibitors (SSRIs) is a frequently prescribed treatment. However, there is limited clinical evidence on the safety of this medication combination in adults with ADHD. Objective To evaluate the safety of administering a combination of SSRI and methylphenidate in adults with ADHD and comorbid depression. Design, Setting, and Participants This cohort study obtained data from a nationwide claims database in South Korea from January 2016 to February 2021. Participants were adults aged 18 years or older with a diagnosis of ADHD and depressive disorder who were prescribed methylphenidate. Comparisons of 4 groups who received prescriptions were conducted: (1) SSRI plus methylphenidate (hereafter, SSRI) group vs methylphenidate-only group and (2) methylphenidate plus fluoxetine (hereafter, fluoxetine) group vs methylphenidate plus escitalopram (hereafter, escitalopram) group (compared to find a preferable treatment option). Data analysis was conducted between July and December 2023. Exposures New users of the methylphenidate and SSRI combination among adults with both ADHD and depressive disorder. Main Outcomes and Measures A total of 17 primary and secondary outcomes, including neuropsychiatric and other events, were assessed, with respiratory tract infection used as a control outcome. Groups were matched at a 1:1 ratio using a propensity score to balance confounders. A Cox proportional hazards regression model was used to calculate hazard ratio (HRs) and 95% CIs. Subgroup analysis by sex and sensitivity analyses in varying epidemiologic settings were conducted. Results The study included 17 234 adults with ADHD (mean [SD] age at study entry, 29.4 [10.8] years; 9079 females [52.7%]). There was no difference in the risk of outcomes between the methylphenidate-only and SSRI groups, except for a lower risk of headache in the SSRI group (HR, 0.50; 95% CI, 0.24-0.99). In sensitivity analyses of fluoxetine vs escitalopram, the risk of hypertension (HR: 1:n matching, 0.26; 95% CI, 0.08-0.67) and hyperlipidemia (HR: 1:n matching, 0.23; 95% CI, 0.04-0.81) was lower in the fluoxetine group than in the escitalopram group. Conclusions and Relevance Results of this study revealed no significant increase in adverse event risk associated with use of SSRI plus methylphenidate vs methylphenidate alone in adults with ADHD and comorbid depression. Instead, the combination was associated with a lower risk of headache.
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Affiliation(s)
- Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
- Department of Medical Sciences, Graduate School of Ajou University, Suwon, South Korea
| | - Chungsoo Kim
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Yunmi Shin
- Department of Psychiatry, Ajou University School of Medicine, Suwon, South Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, South Korea
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, South Korea
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Jusienė R, Lisauskienė L, Baukienė E, Laurinaitytė I, Praninskienė R, Urbonas V. Predictors of children's headaches during the second COVID-19 pandemic wave in the country with long-lasting lockdown. Cent Eur J Public Health 2024; 32:95-100. [PMID: 39069312 DOI: 10.21101/cejph.a8007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 06/28/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES The current study examined the links and interactions among headaches, screen-based media use, physical activity, sleep, and the family environment in Lithuanian school-aged children during the second COVID-19 lockdown. METHODS The study comprised data of 541 children aged 7-14 years from different Lithuania regions, and without chronic health conditions or developmental disorders. Information about the child was provided by their parents or caregivers who filled questionnaire on child's screen time, sleep duration and quality, physical activity, parental distress, parent-child relationship, history of child's headaches and infectious diseases. RESULTS During the study period, 54% of the children had headaches, and the frequency was positively associated with child's age, screen time and parental distress, as well as negatively related to physical activity (PA), sleep quality, and the parent-child relationship. Parental education was related to child's PA, screen time and sleep quality. The results of binary logistic regression analysis and path analysis revealed that sleep quality and parental distress were significant predictors of headaches in children. CONCLUSIONS Family and child or adolescent education and lifestyle modification aiming to improve sleep hygiene and PA, and to reduce screen-based sedentary behaviour should be provided. Family centred approach for more effective coping with distress and improvement of parent-child relationship is also important in treating child and adolescent headache.
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Affiliation(s)
- Roma Jusienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Lina Lisauskienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
- Centre for Obstetrics and Gynaecology, Hospital of Vilnius University Clinics of Santaros, Vilnius, Lithuania
| | - Edita Baukienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Ilona Laurinaitytė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Rūta Praninskienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Vaidotas Urbonas
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Botschek T, Monninger M, Schäfer D, Cevik R, Memis K, Müller U, Monninger M, Brosig B. Evaluation of multidimensional pediatric-psychosomatic inpatient therapy: a pilot study comparing two treatment modalities. Front Psychol 2023; 14:1022409. [PMID: 37346420 PMCID: PMC10279886 DOI: 10.3389/fpsyg.2023.1022409] [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: 08/18/2022] [Accepted: 05/18/2023] [Indexed: 06/23/2023] Open
Abstract
Introduction Multidimensional pediatric-psychosomatic inpatient treatment should be considered a highly relevant concept in the German healthcare system. This treatment concept has been successfully integrated to support youth with mental disorders and patients with chronic somatic conditions. Studies on treatment impact and empirical evidence of pediatric-psychosomatic inpatient therapies are rare, despite their clinical significance. Therefore, the study aims to provide initial indications of what constitutes to enhanced treatment effectiveness by comparing two different pediatric-psychosomatic inpatient treatment concepts. The clinics are comparable regarding the treated disorders, which include: dissociative, mood, and somatoform disorders, and psychological factors associated with chronic somatic conditions. Multidimensional treatment in both clinics include components of individual and family therapy, along with group-, art-, music-, creative-, and physio-therapy. Both clinics differed regarding their treatment philosophy in which; Clinic A practiced psychodynamic behavioral elements more strongly, while Clinic B rooted itself more strongly with psychoanalysis and family-dynamic practices. Method Each clinic recruited 25 patients for the study. They completed two questionnaires both at admission and discharge, which measured general behavioral and emotional problems (YSR); and, respectively, difficulties in emotion perception and processing (TAS-26). The effectiveness of the treatment was examined by conducting one-sample t-test and effect sizes for each clinic. To obtain information on differentiating treatment effects, mixed ANOVAs were calculated. For estimating its influence, the treatment duration was taken into account as a covariate calculating an ANCOVA. Results In both settings, treatment effects can be observed regarding internalizing problems. For alexithymia, no effects were seen in Clinic B, while in Clinic A, there was a significant reduction. When comparing both clinics, the ANOVAs showed significant interaction effects displaying advantages for Clinic A in the reduction of internalizing, total behavioral problems and alexithymia. Taking into account the treatment duration as a covariate, those effects level out. Significant differences between the clinics were no longer statistically detectable. Discussion The present study provides substantial preliminary indications on the effectiveness of multidimensional pediatric-psychosomatic inpatient therapy, which seems suitable for alleviating the general symptom burden and problems by identifying and processing emotions. Furthermore, the results indicate that an extended treatment duration may contribute to more pronounced effects.
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Affiliation(s)
- Tim Botschek
- Family Psychosomatics, Department of Pediatrics and Neonatology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Maximilian Monninger
- Department of General Pediatrics, University Children’s Hospital Muenster, Münster, Germany
| | | | - Rabia Cevik
- Department of General Pediatrics, University Children’s Hospital Muenster, Münster, Germany
| | - Kübra Memis
- Family Psychosomatics, Department of Pediatrics and Neonatology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Ulrike Müller
- Family Psychosomatics, Department of Pediatrics and Neonatology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Martina Monninger
- Department of General Pediatrics, University Children’s Hospital Muenster, Münster, Germany
| | - Burkhard Brosig
- Family Psychosomatics, Department of Pediatrics and Neonatology, Justus-Liebig-University Giessen, Giessen, Germany
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11
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Connelly M, Dilts J, Boorigie M, Gerson T. A Prospective Evaluation of the Effects of the COVID-19 Pandemic on Youth with Primary Headache Disorders. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020184. [PMID: 36832313 PMCID: PMC9954271 DOI: 10.3390/children10020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/22/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Alterations in certain academic and social/family routines during the COVID-19 pandemic have been speculated to be either a risk factor or buffer for poor health outcomes for youth with stress-sensitive health conditions such as primary headache disorders. The current study evaluated patterns and moderators of pandemic impacts on youth with primary headache disorders, with an aim of extending our understanding of the relationship between stress, resilience, and outcomes in this population. Children recruited from a headache clinic in the midwestern United States reported on their headaches, schooling, routines, psychological stress, and coping at four timepoints ranging from within a few months of the pandemic onset to a long-term follow-up 2 years later. Changes in headache characteristics over time were analyzed for association with demographics, school status, altered routines, and stress, and coping. At baseline, 41% and 58% of participants reported no change in headache frequency or intensity, respectively, relative to pre-pandemic levels, with the remainder almost equally divided between reporting an improvement or worsening. The results of multilevel growth model analyses indicated that headache intensity remained more elevated over time since the start of the pandemic for respondents whose stress scores were relatively higher (b = 0.18, t = -2.70, p = 0.01), and headache-related disability remained more elevated over time for older respondents (b = 0.01, t = -2.12, p = 0.03). The study results suggest, overall, that the outcomes of primary headache disorders in youth were not systematically altered by the COVID-19 pandemic.
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Affiliation(s)
- Mark Connelly
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
- Correspondence:
| | - Jennifer Dilts
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | | | - Trevor Gerson
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
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12
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Abstract
It is well established that migraine is a multifactorial disorder. A deep understanding of migraine should be based upon both the underlying traits and the current states affected by different physiological, psychological, and environmental factors. At this point, there is no framework fully meeting these criteria. Here, we describe a broader view of the migraine disorder defined as a dysfunctional brain state and trait interaction. In this model, we consider events that may enhance or diminish migraine responsivity based on an individual's trait and state. This could provide an expanded view for considering how migraine attacks are sometimes precipitated by "triggers" and sometimes not, how these factors only lead to migraine attacks in migraine patients, or how individuals with an increased risk for migraine do not show any symptoms at all. Summarizing recent studies and evidence that support the concept of migraine as a brain state-trait interaction can also contribute to improving patient care by highlighting the importance of precision medicine and applying measures that are able to capture how different traits and states work together to determine migraine.
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13
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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: 15] [Impact Index Per Article: 5.0] [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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14
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Kalantar Hormozi B, Tavoli A, Abdollahi A. Perceived Parental Styles and Alexithymia in Adult Iranian Migraine Patients: The Mediating Role of Emotional Schemas. The Journal of Genetic Psychology 2022; 183:250-262. [PMID: 35356843 DOI: 10.1080/00221325.2022.2051421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Migraine, which is a highly prevalent headache, is often comorbid with alexithymia. Parental styles contribute to the development of alexithymia. The core psychological mechanisms that connect parenting to alexithymia and can be targeted in psychotherapy are not yet studied. The objective of this study was to explore the role of emotional schemas as a possible mediator between perceived parental styles and alexithymia in migraine patients. Study participants consisted of 208 (67 males and 141 females) Iranians who completed the Farsi version of Toronto Alexithymia Scale (FTAS-20), Leahy Emotional Schema Scale (LESS II), and Measure of Parental Styles (MOPS) online. For mediation analysis, structural equation modeling was used based on Baron and Kenny's mediation model. The results demonstrated that mother overprotection and mother indifference were significantly related to alexithymia in migraine patients. Emotional schemas and alexithymia were also positively and significantly related. Additionally, mother overprotection and father indifference showed positive and significant covariation with emotional schemas. Data analysis with structural equation modeling revealed that emotional schemas partially mediate the relationship between parental styles and alexithymia in migraine patients. The current study expands our knowledge of possible mechanisms that relate childhood experiences of being parented and alexithymia in migraine patients. Findings of this research imply psychological treatments can benefit from targeting emotional schemas in migraine patients with alexithymia.
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Affiliation(s)
- Bessat Kalantar Hormozi
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Azadeh Tavoli
- Department of Psychology, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
| | - Abbas Abdollahi
- Department of Counselling, Faculty of Education and Psychology, Alzahra University, Tehran, Iran
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15
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Lim TJ, Kong J, Nam SO, Byun SY, Jung S, Yeon GM, Lee YJ. Effect of the COVID-19 Pandemic on Headache in Pediatric Migraine Patients at a Single Tertiary Center. ANNALS OF CHILD NEUROLOGY 2022. [DOI: 10.26815/acn.2022.00038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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16
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Pan PY, Jonsson U, Şahpazoğlu Çakmak SS, Häge A, Hohmann S, Nobel Norrman H, Buitelaar JK, Banaschewski T, Cortese S, Coghill D, Bölte S. Headache in ADHD as comorbidity and a side effect of medications: a systematic review and meta-analysis. Psychol Med 2022; 52:14-25. [PMID: 34635194 PMCID: PMC8711104 DOI: 10.1017/s0033291721004141] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/08/2021] [Accepted: 09/23/2021] [Indexed: 01/02/2023]
Abstract
There is mixed evidence on the association between headache and attention-deficit/hyperactivity disorder (ADHD), as well as headache and ADHD medications. This systematic review and meta-analysis investigated the co-occurrence of headache in children with ADHD, and the effects of ADHD medications on headache. Embase, Medline and PsycInfo were searched for population-based and clinical studies comparing the prevalence of headache in ADHD and controls through January 26, 2021. In addition, we updated the search of a previous systematic review and network meta-analysis of double-blind randomized controlled trials (RCTs) on ADHD medications on June 16, 2020. Trials of amphetamines, atomoxetine, bupropion, clonidine, guanfacine, methylphenidate, and modafinil with a placebo arm and reporting data on headache as an adverse event, were included. Thirteen epidemiological studies and 58 clinical trials were eligible for inclusion. In epidemiological studies, a significant association between headache and ADHD was found [odds ratio (OR) = 2.01, 95% confidence interval (CI) = 1.63-2.46], which remained significant when limited to studies reporting ORs adjusted for possible confounders. The pooled prevalence of headaches in children with ADHD was 26.6%. In RCTs, three ADHD medications were associated with increased headache during treatment periods, compared to placebo: atomoxetine (OR = 1.29, 95% CI = 1.06-1.56), guanfacine (OR = 1.43, 95% CI = 1.12-1.82), and methylphenidate (OR = 1.33, 95% CI = 1.09-1.63). The summarized evidence suggests that headache is common in children with ADHD, both as part of the clinical presentation as such and as a side effect of some standard medications. Monitoring and clinical management strategies of headache in ADHD, in general, and during pharmacological treatment are recommended.
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Affiliation(s)
- Pei-Yin Pan
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Ulf Jonsson
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Neuroscience, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Sabriye Selin Şahpazoğlu Çakmak
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Alexander Häge
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Sarah Hohmann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Hjalmar Nobel Norrman
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Jan K. Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, and Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, Netherlands
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Samuele Cortese
- Faculty of Environmental and Life sciences & Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK
- Solent NHS Trust, Southampton, UK
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
- New York University Child Study Center, New York, NY, USA
| | - David Coghill
- Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, and Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia
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17
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Kobus M, Sitek A, Antoszewski B, Rożniecki J, Pełka J, Żądzińska E. Prenatal oestrogen-testosterone balance as a risk factor of migraine in adults. J Headache Pain 2021; 22:119. [PMID: 34620097 PMCID: PMC8499432 DOI: 10.1186/s10194-021-01326-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/07/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Migraine is a common neurological disease with extremely debilitating, but fully reversible symptoms. Women suffer from migraine more often than men. It was assumed that fluctuation of oestrogen level during menstrual cycle is one of many factors responsible for more frequent migraine attacks. The second-to-fourth digit ratio (2D:4D) is considered as an indicator of prenatal sex steroids. Balance of prenatal androgens (testosterone) and oestrogen has been studied in numerous diseases that are affected by hormones. However, the relationship between migraine and the sex steroids balance in prenatal development is still unexplained. The aim of this paper is to provide an evidence of relationship between prenatal oestrogen and testosterone exposure following 2D:4D digit ratio, and migraine prevalence in adults. METHODS We examined a group of 151 adults (33 males, 118 females) with migraine and a control group of 111 adults (45 males, 66 females). 2D:4D digit ratio of both hands was measured using sliding Vernier calliper. RESULTS Significant differences were found in the right hand. Female migraineurs had lower value of 2D:4D ratio than the control group and the right 2D:4D was lower than left 2D:4D (Δ2D:4D), suggesting prenatal testosterone dominance. The opposite relationship was observed in males. Male migraineurs had higher value of 2D:4D ratio and Δ2D:4D was greater than the control group, suggesting prenatal oestrogen dominance. CONCLUSIONS Our results suggest that depending on sex, different proportion of prenatal sex steroids might be a risk factor of migraine in adults. Women with migraine were presumably exposed in prenatal life to higher testosterone levels relative to oestrogen, while men with migraine were probably exposed in prenatal life to higher levels of oestrogen relative to testosterone.
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Affiliation(s)
- Magdalena Kobus
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237, Lodz, Poland.
| | - Aneta Sitek
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237, Lodz, Poland
| | - Bogusław Antoszewski
- Department of Plastic, Reconstructive and Aesthetic Surgery, Institute of Surgery, Medical University of Lodz, Lodz, Poland
| | - Jacek Rożniecki
- Department of Neurology, Stroke and Neurorehabilitation, Medical University of Lodz, Lodz, Poland
| | - Jacek Pełka
- Department of Neurology, Norbert Barlicki Memory University Teaching Hospital, Lodz, Poland
| | - Elżbieta Żądzińska
- Department of Anthropology, Faculty of Biology and Environmental Protection, University of Lodz, 90-237, Lodz, Poland
- Biological Anthropology and Comparative Anatomy Research Unit, School of Medicine, The University of Adelaide, Adelaide, South Australia, 5005, Australia
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18
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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: 1.3] [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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19
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Cozzi G, Lucarelli A, Borrometi F, Corsini I, Passone E, Pusceddu S, Morabito G, Barbi E, Benini F. How to recognize and manage psychosomatic pain in the pediatric emergency department. Ital J Pediatr 2021; 47:74. [PMID: 33766115 PMCID: PMC7992953 DOI: 10.1186/s13052-021-01029-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/15/2021] [Indexed: 01/19/2023] Open
Abstract
Aim Children and adolescents affected by somatization and somatic symptom disorder commonly refer to emergency services. Due to the absence of specific guidelines for the emergency setting and to a possible lack of knowledge, these patients are at risk of being unrecognized and mismanaged. This study aims at proposing a clinical practice to approach and manage these patients and their families in the emergency setting. Methods This manuscript derived from the work of a research group of italian pediatric emergency physicians and anesthesiologists, with an expertise in pain management, members of the PIPER group. The research group reviewed the literature about psychosomatic pain and somatic symptom disorder and developed a clinical practice specific for the pediatric emergency setting. Results The manuscript provides information about the main clinical features shared by patients with psychosomatic pain and about current diagnostic criteria and appropriate management in the emergency setting. Furthermore, it highlights the possible pitfalls in which the emergency physician may run into dealing with these patients. Conclusion This clinical practice should be seen as a starting point toward a better understanding of patients with psychosomatic pain and a standardization of care in the pediatric emergency setting.
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Affiliation(s)
- Giorgio Cozzi
- Pediatric Emergency Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy.
| | - Annunziata Lucarelli
- Department of Paediatrics and Emergency, Giovanni XXIII Children's Hospital, University of Bari, Bari, Italy
| | - Fabio Borrometi
- Pediatric Pain Service and Palliative Care, Department of Oncology, Pausilipon Hospital, AORN Santobono Pausilipon, Naples, Italy
| | - Ilaria Corsini
- Pediatric Emergency Unit, Department of Medical and Surgical Sciences (DIMEC), Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Eva Passone
- Pediatric Clinic, Department of Clinical and Experimental Sciences, DAME, ASUFC S. Maria Della Misericordia, University of Udine, Udine, Italy
| | - Sara Pusceddu
- Pediatric Department, Ospedale S. Maria della Scaletta AUSL, Imola, Italy
| | - Giuliana Morabito
- Pediatric and Neonatology Division, Azienda Ospedaliera Santa Maria degli Angeli, Pordenone, Italy
| | - Egidio Barbi
- Pediatric Emergency Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Franca Benini
- Paediatric Palliative Care - Pain Service Department of Women's and Children's Health, University of Padua, Padua, Italy
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20
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The Influence of Lifestyle Factors on the Burden of Pediatric Migraine. J Pediatr Nurs 2021; 57:79-83. [PMID: 33353788 DOI: 10.1016/j.pedn.2020.12.003] [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] [Received: 05/08/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 11/21/2022]
Abstract
There is a gap in patient education and coaching of lifestyle factors related to pediatric migraine, which nurses are in a unique position to fill in order to provide comprehensive care to these patients. In order to help fill this gap, we conducted a targeted review of studies examining migraine and lifestyle factors in children and adolescents. Studies older than 2010, studies examining adults above the age of 18, studies not available in the English language, and secondary sources were excluded from the review. A final sample of 42 studies was included in this review. Lifestyle factors including stress, sleep, obesity, and diet were identified as playing a significant role in increasing the frequency, severity, and duration of migraine attacks in pediatric patients. Based on these findings, a framework is discussed for practical applications of this knowledge by nursing staff working in primary and specialty care clinics.
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21
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Dallavalle G, Pezzotti E, Provenzi L, Toni F, Carpani A, Borgatti R. Migraine Symptoms Improvement During the COVID-19 Lockdown in a Cohort of Children and Adolescents. Front Neurol 2020; 11:579047. [PMID: 33133010 PMCID: PMC7578413 DOI: 10.3389/fneur.2020.579047] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/04/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Pediatric migraine is among the most common primary or comorbid neurologic disorders in children. Psychological stressors are widely acknowledged as potential triggers involved in recurring episodes of pediatric migraine. As the COVID-19 emergency may have affected the levels of stress perceived by children and adolescents with migraine, the present study was aimed to understand the effect of COVID-19 emergency on symptoms intensity and frequency in pediatric patients. Methods: A cohort of 142 child and adolescent patients with a diagnosis of migraine was enrolled at the Child Neurology and Psychiatry Unit of the IRCCS Mondino Foundation in Pavia (Italy). Socio-demographic and clinical characteristics were obtained from medical records. An on-line survey was used to collect information on COVID-19 exposure, stress response to the lockdown period, anxious symptoms during COVID-19 emergency, as well as migraine symptoms intensity and frequency before and during the lockdown. Results: The great majority were outpatients (n = 125, 88.0%), 52 (36.6%) had migraine with aura, whereas, 90 (63.4%) had migraine without aura. All the patients reporting worsening symptoms progression before COVID-19, had reduced intensity during the lockdown (χ2 = 31.05, p < 0.0001). Symptoms frequency reduction was observed in 50% of patients presenting worsening symptoms before the lockdown, 45% of those who were stable, and 12% of those who were already improving. All patients who had resolved symptoms before COVID-19 were stable during the lockdown (χ2 = 38.66, p < 0.0001). Anxious symptomatology was significantly associated with greater migraine symptoms frequency (χ2 = 19.69, p < 0.001). Repeating the analysis separately for individuals with and without aura did not affect the findings and significant associations were confirmed for both the patients' subgroups. Discussion: A significant reduction of migraine symptoms intensity and frequency was observed in pediatric patients during the COVID-19 lockdown phase in northern Italy. The improvement in both intensity and frequency of the migraine symptoms was especially significant in patients who were stable or worsening before the lockdown. The reduction of symptoms severity during a period of reduced environmental challenges and pressures further highlights the need of providing effective training in stress regulation and coping for these patients.
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Affiliation(s)
| | - Elena Pezzotti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Livio Provenzi
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Federico Toni
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Adriana Carpani
- Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy
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Bao J, Ma M, Dong S, Gao L, Li C, Cui C, Chen N, Zhang Y, He L. Early Age of Migraine Onset is Independently Related to Cognitive Decline and Symptoms of Depression Affect Quality of Life. Curr Neurovasc Res 2020; 17:177-187. [PMID: 32031072 PMCID: PMC7536790 DOI: 10.2174/1567202617666200207130659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 01/16/2020] [Accepted: 01/18/2020] [Indexed: 02/08/2023]
Abstract
Background People with migraine experience cognitive decline more often than healthy controls, resulting in a significant functional impact. Early identifying influencing factors that contribute to cognitive decline in migraineurs is crucial for timely intervention. Although migraine may onset early in childhood and early onset migraine is related to significant disability, there is no research investigating the association between the age of migraine onset and migraineurs’ cognitive decline. Therefore we aim to explore possible factors that correlate to the cognitive function of migraineurs, especially focus on age of migraine onset. Methods 531 patients with migraine were included. Data on demographics and headache-related characteristics were collected and evaluated using face-to-face interviews and questionnaires. We used the Montreal Cognitive Assessment scale to assess cognitive function. In addition, we analyzed independent correlations between cognitive decline and the age of migraine onset in patients with migraine. And all patients completed the Headache Impact Test-6 to evaluate their quality of life. Results Migraineurs with cognitive decline showed significant differences from those without in age (OR=1.26, P<0.0001), years of education (OR=0.89, P=0.0182), the intensity of headache (OR=1.03, P=0.0217), age of onset (OR=0.92, P<0.0001) and anxiety scores (OR=1.09, P=0.0235). Furthermore, there was no interaction in the age of onset between subgroups. Multivariate linear regression analyses of HIT-6 scores showed that the intensity of headache (β=0.18, P<0.0001) and depression scores (β=0.26, P=0.0009) had independent effects on decreased quality of life. Conclusion Our findings suggest that younger age of migraine onset is independently related to migraineurs’ cognitive decline, and migraine accompanying anxiety symptoms significantly related to decreased quality of life in migraineurs.
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Affiliation(s)
- Jiajia Bao
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu 610041, Sichuan, China
| | - Mengmeng Ma
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu 610041, Sichuan, China
| | - Shuju Dong
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu 610041, Sichuan, China
| | - Lijie Gao
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu 610041, Sichuan, China
| | - Changling Li
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu 610041, Sichuan, China
| | - Chaohua Cui
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu 610041, Sichuan, China
| | - Ning Chen
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu 610041, Sichuan, China
| | - Yang Zhang
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu 610041, Sichuan, China
| | - Li He
- Department of Neurology, West China Hospital, Sichuan University, No. 37, Wainan Guoxue Xiang, Chengdu 610041, Sichuan, China
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Klausen SH, Rønde G, Tornøe B, Bjerregaard L. Nonpharmacological Interventions Addressing Pain, Sleep, and Quality of Life in Children and Adolescents with Primary Headache: A Systematic Review. J Pain Res 2019; 12:3437-3459. [PMID: 31920368 PMCID: PMC6939407 DOI: 10.2147/jpr.s216807] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/12/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose Children and adolescents with primary headache are at risk of persistent somatic symptoms and reduced quality of life (Qol) due to pain and pain-related behaviors, such as avoiding school and activities. Sleep is essential to health, and children and adolescents with primary headaches have more sleep complaints than do healthy controls. A treatment approach that addresses multifactorial causes is likely important. Nonpharmacological interventions seem promising. However, knowledge about effective strategies is limited. The objective of this review is to assess the effect of nonpharmacological interventions in randomized controlled trials (RCTs) among children and adolescents with primary headache in order to identify useful strategies. Patients and methods Outcome measures are pain, sleep, Qol, and coping versus no intervention or control intervention. Medline, CINAHL, EMBASE, and PsycINFO were searched for eligible trials. ClinicalTrials.gov. was searched for ongoing trials. Initial searches yielded 2588 publications. After initial screening and subsequent full-text review and quality assessment, 13 RCTs reported in 15 articles were selected for review. All reviewers independently assessed study quality using the CONSORT criteria for nonpharmacological interventions. Results Cognitive behavioral therapy (CBT), including education on pain-related topics, sleep, coping, and stress management, is an effective strategy for reducing headache and pain within groups over time. Fifteen studies assessed pain, 3 studies assessed sleep, 6 studies assessed Qol, and 11 studies assessed coping. Conclusion Strategies identified as useful were parts of CBT interventions. However, it was not possible to identify a single effective intervention addressing pain, sleep, Qol, and coping in children and adolescents with headache, primarily because sleep was infrequently addressed. Various aspects of Qol and coping strategies were assessed, rendering comparison difficult. Strategies for future interventions should include descriptions of theory-driven CBT interventions, depending on clinical setting and based on local resources, to promote a solid evidence base for nonpharmacological interventions.
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Affiliation(s)
| | - Gitte Rønde
- Department of Pediatrics, Zealand University Hospital, Roskilde, Denmark
| | - Birte Tornøe
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Lene Bjerregaard
- Open Patient Data Explorative Network (OPEN), University of Southern Denmark (SDU), Odense, Denmark
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Baraldi C, Gherpelli C, Alicandri Ciufelli M, Monzani D, Pini LA, Pani L, Guerzoni S. A case-control study of visually evoked postural responses in childhood with primary headaches. Neurol Sci 2019; 41:305-311. [PMID: 31502001 DOI: 10.1007/s10072-019-04072-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 09/04/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Disorientation, nausea, confusion, dizziness, and displacement are frequently complained by headache-suffering children. Anyhow, the cause of these symptoms is still unclear, and a dysfunction of vestibular pathways or their alteration due to central pain pathways hyper-activation, has been proposed. The aim of this study is to use posturography to explore the balance function of headache-suffering children during pain-free periods. METHODS Posturography was performed on 19 migraineurs, 11 tension-type headache sufferers, and 20 healthy controls. Posturographic measures were performed during headache-free periods under different conditions: with eyes opened, eyes closed, and during right and left optokinetic stimulation. The last 2 conditions were used to mimic unreliable visual signals that can confound vestibular system. RESULTS During eyes-closed conditions, headache-suffering children displayed higher displacements than healthy controls, since statokinesiogram surface was higher in tension-type headache sufferers and migraineurs compared with controls (P value = 0.0095). Romberg's index, indicating the overall stability of the subject, was lower in healthy controls than in headache sufferers (P = 0.0139), thus suggesting a vestibular impairment in the seconds. Moreover, both during right and left optokinetic stimulation, the statokinesiogram length was higher in headache-suffering children (P < 0.0001). Thereafter, statokinesiogram surface was higher in migraineurs during right optokinetic stimulation (P = 0.0388) than in tension-type headache sufferers when stimulation was directed on the opposite side (P = 0.0249). CONCLUSIONS These results suggest a central alteration of vestibular pathways in headache-suffering children, that makes balance function more dependent from visual inputs than healthy subjects, even in inter-ictal phases.
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Affiliation(s)
- Carlo Baraldi
- School of Pharmacology and Clinical Toxicology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy.
| | - Chiara Gherpelli
- Otolaryngology Unit, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
| | | | - Daniele Monzani
- Otolaryngology Unit, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
| | - Luigi Alberto Pini
- Medical Toxicology Unit- Headache and Drug Abuse Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
| | - Luca Pani
- Section of Pharmacology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41124, Modena, Italy
| | - Simona Guerzoni
- Medical Toxicology Unit- Headache and Drug Abuse Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
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The Relationship between Infant Colic and Migraine as well as Tension-Type Headache: A Meta-Analysis. Pain Res Manag 2019; 2019:8307982. [PMID: 31316683 PMCID: PMC6604354 DOI: 10.1155/2019/8307982] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/25/2019] [Accepted: 05/09/2019] [Indexed: 01/01/2023]
Abstract
Background Infant colic is a common benign disease during early infancy. Migraine and tension-type headache (TTH) are the most common primary headache forms among pediatric population. Several studies have investigated the incidence of infant colic in patients with migraine and TTH. The meta-analysis was to assess the relationship between infant colic and migraine as well as TTH. Methods PubMed, Web of Science, and Cochrane Library were searched until August 16, 2018, for potential studies. Data were extracted by two independent authors and analyzed using RevMan 5.2 software. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to determine the association between infant colic and migraine as well as TTH, respectively. Results A total of 148 studies were found, and 7 studies were finally included. A higher incidence of colic during infancy was revealed in migraine patients than controls (P=0.05, OR: 2.51, 95% CI: 1.32-4.77) and TTH subjects (P=0.02, OR: 0.33, 95% CI: 0.13-0.86), respectively. And no significances were found between TTHs with controls (P=0.51, OR: 1.17, 95% CI: 0.73-1.89). Conclusion This meta-analysis indicated that migraine was associated with increased incidence of infantile colic history, but TTH incidence was not relevant with the incidence of infantile colic history.
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An YC, Liang CS, Lee JT, Lee MS, Chen SJ, Tsai CL, Lin GY, Lin YK, Yang FC. Effect of Sex and Adaptation on Migraine Frequency and Perceived Stress: A Cross-Sectional Case-Control Study. Front Neurol 2019; 10:598. [PMID: 31231306 PMCID: PMC6560056 DOI: 10.3389/fneur.2019.00598] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 05/21/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Perceived stress has been related to migraine. The relationship between sex, migraine frequency, and severity of perceived stress remains unclear. We investigated perceived stress among migraineurs. Methods: This cross-sectional case-control study involved 577 clinical outpatients at a tertiary hospital in Taiwan. Demographic and clinical data, including migraine characteristics, were collected. Migraineurs were stratified by episode frequency, aura and sex, and analyses were controlled for confounding variables. Multivariable linear regressions were used to inspect whether migraine frequency (1-4, 5-8, 9-14, or ≥15 headache days per month) was associated with perceived stress as assessed by the Perceived Stress Scale (PSS). Results: Perceived stress was significantly higher in high frequency migraineurs (mean ± standard deviation (SD), 23.3 ± 8.7) than in low frequency migraineurs (mean ± SD, 21.9 ± 9.2; P < 0.05). After stratifying the analysis by sex, this result was observed in male subjects, but was insignificant in female subjects. In addition, the relationship between migraine frequency and perceived stress was not prominent in aura-present or -absent subgroups. Conclusions: Higher perceived stress was associated with higher migraine frequency, but not in chronic migraine and female subgroups. Adaptation to migraine and various psychiatric comorbidities may contribute to these associations.
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Affiliation(s)
- Yu-Chin An
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Sy-Jou Chen
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Lin Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Guan-Yu Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Kai Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Filiz S, Kutluk MG, Uygun DFK. Headache deteriorates the quality of life in children with chronic spontaneous urticaria. Allergol Immunopathol (Madr) 2019; 47:254-259. [PMID: 30686612 DOI: 10.1016/j.aller.2018.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 09/18/2018] [Accepted: 09/20/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Quality of life, which is impaired in patients with chronic spontaneous urticaria (CSU), is influenced by comorbid mental disorders. Headaches could be another comorbid mental disorder that affects quality of life in children with CSU. OBJECTIVES To investigate the effect of headaches on urticaria symptoms, disease activity and quality of life in children with CSU. METHODS A total of 83 patients with CSU were enrolled in the study and were separated into two groups as those with or without headache. Demographic and clinical characteristics were studied with the Urticaria Activity Score (UAS7), Urticaria Control test (UCT) and Chronic Urticaria Quality of Life Questionnaire (CU-Q2QoL). The headache questionnaire designed according to the Department of International Classification of Headache Disorders, second edition (ICHD-II) was used and VAS (Visual Analogue Scale) and NRS (Numerical Rating Scale) were used to assess the pain measurement. In patients diagnosed with migraine, the paediatric Migraine Disability Assessment Scale (PedMIDAS) was applied. RESULTS CU-QoL total scores were significantly higher in patients with CSU with headache than in those without headache (p=0.015). In the five domains of CU-QoL, impact of daily life activities domain and sleep problems domain had higher scores in CSU with headache (p=0.008, 0.028, respectively). There was no significant relationship between UCT, UAS and CU-QoL and headache severity (p<0.05). No differences were found between the groups in respect of duration of urticaria, UAS7 and UCT. CONCLUSION Headache may be an important factor that affects and impairs quality of life in children with chronic urticaria.
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Affiliation(s)
- S Filiz
- Training and Research Hospital, Department of Pediatric Allergy and Immunology, Antalya, Turkey.
| | - M G Kutluk
- Training and Research Hospital, Department of Pediatric Neurology, Antalya, Turkey
| | - D F K Uygun
- Akdeniz University, Department of Pediatric Allergy and Immunolgy, Antalya, Turkey
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Exploring Traits of Autism and Their Impact on Functional Disability in Children with Somatic Symptom Disorder. J Autism Dev Disord 2018; 49:729-737. [PMID: 30229361 DOI: 10.1007/s10803-018-3751-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Subclinical traits of autism were measured in children with somatic symptom disorder (SSD, n = 28) and compared with age-matched controls (n = 26) using the Autism Spectrum Quotient (AQ) children's version. The KINDLR quality of life questionnaire was used to assess functional disability. Although there was no significant group difference in total traits of autism, SSD group had significantly greater difficulty in attention switching domain. Logistic regression analysis confirmed attention switching and age were associated with increased likelihood of SSD. In SSD group, difficulty in attention switching significantly negatively correlated with total, family, and friends quality of life scores. In conclusion, assessment and treatment targeting difficulties in attention switching could be useful when dealing with children with SSD.
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Torres-Ferrus M, Vila-Sala C, Quintana M, Ajanovic S, Gallardo VJ, Gomez JB, Alvarez-Sabin J, Macaya A, Pozo-Rosich P. Headache, comorbidities and lifestyle in an adolescent population (The TEENs Study). Cephalalgia 2018; 39:91-99. [PMID: 29771141 DOI: 10.1177/0333102418777509] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To evaluate the prevalence and characteristics of headache and its relationship with comorbidities and lifestyle in a teenage population. METHODS This is a cross-sectional study. Data was collected from students aged 12-18 years from six different schools in Catalonia, Spain. They completed an anonymous questionnaire with demographic, lifestyle, medical data, presence of recurrent headaches and its features, and completed the Strengths and Difficulties Questionnaire. We defined probable migraine if headache presented ≥ 3 ICHD-3 beta criteria for migraine. An analysis was performed to evaluate headache characteristics and compare lifestyles between those with or without headache. RESULTS 1619 out of 1873 students completed the survey (response rate 86.4%). From these, 30.5% suffered from recurrent headache and 11.3% had migraine features; 32.9% of adolescents with headache had at least one episode per week and 44.1% showed some degree of headache-related disability measured by the PedMIDAS scale. In a univariate analysis, headache was significantly more frequent in girls (35.1% vs. 25.5%, p < 0.001), teenagers with poor sleeping habits (36.6% vs. 27.6%, p < 0.001), lower physical activity ( p = 0.002), those who did not have breakfast (37.3 vs. 28.4%, p = 0.001), smokers (10.5% vs. 4.9%, p < 0.001) and caffeine overusers (30.9% vs. 24.7%, p = 0.009). Comorbidities significantly associated with headache were: allergies (38.8% vs. 29.3%, p = 0.007), other chronic pain disorders (44.7% vs. 27.6% p < 0.001), mental health problems (53.2% vs. 29.0%, p < 0.001) and worse SDQ scores ( p < 0.001). CONCLUSIONS Headache is a common health problem among adolescents which impacts their quality of life. Headache is associated with presence of "unhealthy lifestyle" and other medical comorbidities. Educational initiatives should be started.
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Affiliation(s)
- Marta Torres-Ferrus
- 1 Headache & Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Headache Research Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carme Vila-Sala
- 1 Headache & Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Manuel Quintana
- 2 Headache Research Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sara Ajanovic
- 3 Pediatric Neurology Section, Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Victor José Gallardo
- 2 Headache Research Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Juan Bernardo Gomez
- 2 Headache Research Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - José Alvarez-Sabin
- 1 Headache & Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Alfons Macaya
- 3 Pediatric Neurology Section, Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain.,4 Pediatric Neurology Research Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Patricia Pozo-Rosich
- 1 Headache & Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,2 Headache Research Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
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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: 1.6] [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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Efficiency of Kinesio Taping in Adolescents with Cervicogenic Headache: a Blind Placebo-Controlled Study. BIONANOSCIENCE 2018. [DOI: 10.1007/s12668-018-0506-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Esposito M, Messina A, Monda V, Bitetti I, Salerno F, Precenzano F, Pisano S, Salvati T, Gritti A, Marotta R, Lavano SM, Lavano F, Maltese A, Parisi L, Salerno M, Tripi G, Gallai B, Roccella M, Bove D, Ruberto M, Toraldo R, Messina G, Carotenuto M. The Rorschach Test Evaluation in Chronic Childhood Migraine: A Preliminary Multicenter Case-Control Study. Front Neurol 2017; 8:680. [PMID: 29312117 PMCID: PMC5733029 DOI: 10.3389/fneur.2017.00680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/29/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECT About 1.2-3.2% of children at 7 years of age with increasing age up to 4-19% in adolescents are suffering from migraine without aura (MwA). The aim of the present study is investigating the personality style associated with children and adolescents affected by MwA, administrating the Rorschach test, and comparing with typical developing healthy controls (TD). METHODS 137 patients (74 males), aged 7.3-17.4 years (mean age 11.4, SD 3.02 years), affected by MwA according to the IHs-3 criteria. The Rorschach variables were treated as numerical variables and statistically tested with t-Student's analysis. RESULTS No statistical differences were found between the MwA and TD for age (p = 0.55), and gender (p = 0.804). From the comparison between the two samples, MwA group shows lower W responses (p < 0.001), good quality W responses (p < 0.001), high frequency of detailed responses (p < 0.001), the presence of even minor form of good quality responses (p < 0.001), increased presence of animals answers (A%) (p < 0.001), more frequent trivial answers (Ban%) (p < 0.001). DISCUSSION Rorschach interpretation pinpointed many interesting and, perhaps, peculiar aspects in our MwA population such as a trend predisposition for: analytical reasoning rather than synthetic, ease/practicality rather than creativity, oppositionality rather than external adaptation to the environment that may be interpreted as effect of general maladaptivity.
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Affiliation(s)
- Maria Esposito
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vincenzo Monda
- Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetics and Sports Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ilaria Bitetti
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Filomena Salerno
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Francesco Precenzano
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Simone Pisano
- Department of Child and Adolescent Neuropsychiatry, University of Salerno, Salerno, Italy
| | - Tiziana Salvati
- Faculty of Education Science, University Suor Orsola Benincasa of Naples, Naples, Italy
| | - Antonella Gritti
- Faculty of Education Science, University Suor Orsola Benincasa of Naples, Naples, Italy
| | - Rosa Marotta
- Department of Medical and Surgical Science, University Magna Graecia, Catanzaro, Italy
| | | | - Francesco Lavano
- Department of Health Sciences, University “Magna Graecia”, Catanzaro, Italy
| | - Agata Maltese
- Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, Italy
| | - Lucia Parisi
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Margherita Salerno
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Gabriele Tripi
- Department PROSAMI, University of Palermo, Palermo, Italy
- Childhood Psychiatric Service for Neurodevelopmentals Disorders, Chinon, France
| | - Beatrice Gallai
- Centro per la Diagnosi e Cura dei Disturbi dell’apprendimento e del Comportamento Associazione per la ricerca scientifica Fusis, Alvignano, Italy
| | - Michele Roccella
- Child Neuropsychiatry, Department of Psychology and Pedagogical Sciences, University of Palermo, Palermo, Italy
| | - Domenico Bove
- Centro per la Diagnosi e Cura dei Disturbi dell’apprendimento e del Comportamento Associazione per la ricerca scientifica Fusis, Alvignano, Italy
| | - Maria Ruberto
- Department of Medical-Surgical and Dental Specialties, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Roberto Toraldo
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Marco Carotenuto
- Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental and Physical Health, and Preventive Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
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Lo Buono V, Bonanno L, Corallo F, Pisani LR, Lo Presti R, Grugno R, Di Lorenzo G, Bramanti P, Marino S. Functional connectivity and cognitive impairment in migraine with and without aura. J Headache Pain 2017; 18:72. [PMID: 28730563 PMCID: PMC5519515 DOI: 10.1186/s10194-017-0782-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 07/13/2017] [Indexed: 01/03/2023] Open
Abstract
Background Several fMRI studies in migraine assessed resting state functional connectivity in different networks suggesting that this neurological condition was associated with brain functional alteration. The aim of present study was to explore the association between cognitive functions and cerebral functional connectivity, in default mode network, in migraine patients without and with aura, during interictal episodic attack. Methods Twenty-eight migraine patients (14 without and 14 with aura) and 14 matched normal controls, were consecutively recruited. A battery of standardized neuropsychological test was administered to evaluate cognitive functions and all subjects underwent a resting state with high field fMRI examination. Results Migraine patients did not show abnormalities in neuropsychological evaluation, while, we found a specific alteration in cortical network, if we compared migraine with and without aura. We observed, in migraine with aura, an increased connectivity in left angular gyrus, left supramarginal gyrus, right precentral gyrus, right postcentral gyrus, right insular cortex. Conclusion Our findings showed in migraine patients an alteration in functional connectivity architecture. We think that our results could be useful to better understand migraine pathogenesis.
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Affiliation(s)
- Viviana Lo Buono
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy.
| | - Lilla Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Francesco Corallo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Laura Rosa Pisani
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Riccardo Lo Presti
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Rosario Grugno
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Giuseppe Di Lorenzo
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Placido Bramanti
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy
| | - Silvia Marino
- IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113 Via Palermo, C.da Casazza, 98124, Messina, Italy.,Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, Messina, Italy
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