Objective.- To determine whether behavioral and psychiatric disorders occur more frequently in school- age children with migraine headache. To also elucida te treatment response related to comorbid psychiatric or beha...Objective.- To determine whether behavioral and psychiatric disorders occur more frequently in school- age children with migraine headache. To also elucida te treatment response related to comorbid psychiatric or behavioral diagnosis. B ackground.- Recurrent migraine headaches are common in school- age children. C oncurrent behavioral or psychiatric diagnoses could significantly impact headach e frequency, severity, and response to treatment. Methods.- Healthy children fr om 6 to 17 years of age presenting to our headache clinic with migraine headache according to International Headache Society (IHS) criteria were identified. Par ents/guardians were asked to complete the Child Symptom Inventory, 4th edition ( CSI- 4) after written informed consent. Children with positive rating scales un derwent psychological interviews for confirmatory diagnosis. Results were compar ed to controls. Headache patients were assigned our usual treatment paradigm. Response regarding heada che frequency was assessed at 3 months. Results.- A total of 47 patients were d iagnosed with migraine headaches. The mean age was 10.55 years. Thirty controls were identified. After completing the CSI- 4 and confirmatory psychological int erview, 14 of 47 headache patients fulfilled Diagnostic and Statistical Manual ( DSM- 4) criteria for a psychiatric or behavioral disorder. Oppositional defiant disorder (ODD) was significantly represented among children with migraine compa red to the control group of children. Headache patients improved significantly p ost- treatment regarding their headache frequencies regardless of comorbid psyc hiatric or behavioral disorder. No significant differences were noted between bo ys and girls regarding diagnoses or treatment outcome. Conclusion.- ODD was a s ignificant comorbidity in our headache population. Although families complained of significant behavioral symptomatology in their children, most of these sympto ms did not qualify their children for a psychiatric diagnosis and may be related to the stressors of 展开更多
Despite the high prevalence of headaches, multidisciplinary headache clinics are few and their efficacy still needs validation. We set out to describe the procedures, characterizethe patients and evaluate the treatmen...Despite the high prevalence of headaches, multidisciplinary headache clinics are few and their efficacy still needs validation. We set out to describe the procedures, characterizethe patients and evaluate the treatment results in Danish Headache Centre. All clinical records for patients discharged in 2002 were systematically reviewed. Diagnoses were classified in accordance with ICHD- II. Outcome results were analysed with respect to headache diagnoses, frequency, intensity, absence from work and medication use. Five hundred and five patients were included and 336 were eligible for the study. Mean age was 46 years and male/female ratio 1: 2.4. For patients without medication overuse headache (MOH) a reduction in headache frequency (P < 0.01) and intensity (P < 0.05) was seen for frequent episodic and chronic tension-type headache (TTH), migraine, cluster and other headaches. No reduction was seen in post-traumatic headache. Absence from work decreased significantly for migraine (P < 0.001) and frequent episodic TTH (P < 0.05). For patients with MOH a reduction in headache frequency was seen for TTH and migraine (P < 0.001). A specialized headache centre is valuable in treatment of patients with complex headache disorders.展开更多
文摘Objective.- To determine whether behavioral and psychiatric disorders occur more frequently in school- age children with migraine headache. To also elucida te treatment response related to comorbid psychiatric or behavioral diagnosis. B ackground.- Recurrent migraine headaches are common in school- age children. C oncurrent behavioral or psychiatric diagnoses could significantly impact headach e frequency, severity, and response to treatment. Methods.- Healthy children fr om 6 to 17 years of age presenting to our headache clinic with migraine headache according to International Headache Society (IHS) criteria were identified. Par ents/guardians were asked to complete the Child Symptom Inventory, 4th edition ( CSI- 4) after written informed consent. Children with positive rating scales un derwent psychological interviews for confirmatory diagnosis. Results were compar ed to controls. Headache patients were assigned our usual treatment paradigm. Response regarding heada che frequency was assessed at 3 months. Results.- A total of 47 patients were d iagnosed with migraine headaches. The mean age was 10.55 years. Thirty controls were identified. After completing the CSI- 4 and confirmatory psychological int erview, 14 of 47 headache patients fulfilled Diagnostic and Statistical Manual ( DSM- 4) criteria for a psychiatric or behavioral disorder. Oppositional defiant disorder (ODD) was significantly represented among children with migraine compa red to the control group of children. Headache patients improved significantly p ost- treatment regarding their headache frequencies regardless of comorbid psyc hiatric or behavioral disorder. No significant differences were noted between bo ys and girls regarding diagnoses or treatment outcome. Conclusion.- ODD was a s ignificant comorbidity in our headache population. Although families complained of significant behavioral symptomatology in their children, most of these sympto ms did not qualify their children for a psychiatric diagnosis and may be related to the stressors of
文摘Despite the high prevalence of headaches, multidisciplinary headache clinics are few and their efficacy still needs validation. We set out to describe the procedures, characterizethe patients and evaluate the treatment results in Danish Headache Centre. All clinical records for patients discharged in 2002 were systematically reviewed. Diagnoses were classified in accordance with ICHD- II. Outcome results were analysed with respect to headache diagnoses, frequency, intensity, absence from work and medication use. Five hundred and five patients were included and 336 were eligible for the study. Mean age was 46 years and male/female ratio 1: 2.4. For patients without medication overuse headache (MOH) a reduction in headache frequency (P < 0.01) and intensity (P < 0.05) was seen for frequent episodic and chronic tension-type headache (TTH), migraine, cluster and other headaches. No reduction was seen in post-traumatic headache. Absence from work decreased significantly for migraine (P < 0.001) and frequent episodic TTH (P < 0.05). For patients with MOH a reduction in headache frequency was seen for TTH and migraine (P < 0.001). A specialized headache centre is valuable in treatment of patients with complex headache disorders.
