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Risk factors of anxiety and depression in children and adolescents with headache: A cross-sectional study
Institution:1. Unité douleur (UFLD), centre de la migraine de l’enfant (CME), hôpital Armand-Trousseau, 26, avenue du docteur-Arnold-Netter, 75571 Paris cedex 12, France;2. Unité de recherche EA 4072, PSITEC, université Lille 3, domaine universitaire du Pont-de-Bois, BP 60149, 59653 Villeneuve d’Ascq cedex, France;2. Advanced Surgical Technology and Education Center, Inova Fairfax Medical Campus, Falls Church, Virginia;3. Department of Research, Gundersen Medical Foundation, La Crosse, Wisconsin;4. Department of Surgery, Einstein Healthcare Network, Philadelphia, Pennsylvania;5. Department of General Surgery, Gundersen Health System, La Crosse, Wisconsin;1. Department of Brain and Behavioral Sciences, University of Pavia, P.za Botta 11, 27100 Pavia, Italy;2. Faculty of Psychology, University Vita-Salute San Raffaele of Milan, Milan, Italy;3. Faculty of Psychology, Catholic University of Milan, Milan, Italy;4. Istituto Auxologico Italiano, Milan, Italy;5. Department of Neurosciences and Biomedical Technologies, University of Milano Bicocca, Milan, Italy;6. S. Gerardo Hospital Mental Health Care Trust, Monza, Italy
Abstract:IntroductionDespite numerous studies on the association between headache and psychological difficulties in children, the results remain inconclusive.ObjectiveThis cross-sectional study was conducted to clarify the links between anxiety-depression and headache in children. We evaluated the levels of anxious and depressive symptoms and the influence of risk factors: age, sex, headache diagnosis, frequency and history to identify and treat headache sufferers most at risk.MethodData were collected from a clinical sample of 368 children aged 8 to 17 years. First, a structured interview using the International Classification of Headache Disorders (ICHD-II) was used to diagnose 88 patients with migraine (M), 32 with tension-type headache (TTH), and 248 with a combination syndrome (M + TTH). Second, levels of anxiety and depressive symptoms were assessed with the Revised Children's Manifest Anxiety Scale (R-CMAS) and the Multiscore Depression Inventory for Children (MDI-C).ResultsAn ANOVA analysis showed that the mean scores for anxiety and depressive symptom levels were significantly higher among older patients and that only the M + TTH diagnosis was significantly associated with anxiety. Children with clinically significant levels of anxiety symptoms were more prevalent in our sample than in the general population (13% versus 5%). Anxiety and depression were not associated with child sex, headache frequency and history.ConclusionWe propose systematic screening for anxiety in children presenting with headache, particularly adolescents and patients with a combination diagnosis.
Keywords:Adolescent  Anxiety  Child  Depression  Headache  Adolescent  Anxiété  Enfant  Dépression  Céphalée
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