Behavioral management of headache in children and adolescents

Abstract

Headache is the most frequent neurological symptom and the most prevalent pain in children and adolescents, and constitutes a serious health problem that may lead to impairment in several areas. Psychosocial factors, social environment, life events, school and family stressors are all closely related to headaches. A multidisciplinary strategy is fundamental in addressing headache in children and adolescents. Applying such a strategy can lead to reductions in frequency and severity of the pain, improving significantly the quality of life of these children.It has been demonstrated that behavioral intervention is highly effective, especially in the treatment of paediatric headache, and can enhance or replace pharmacotherapy, with the advantage of eliminating dangerous side effects and or reducing costs. Behavioral interventions appear to maximize long-term therapeutic benefits and improve compliance with pharmacological treatment, which has proven a significant problem with child and adolescent with headache.The goal of this review is to examine the existing literature on behavioral therapies used to treat headache in children and adolescents, and so provide an up-to-date picture of what behavioral therapy is and what its effectiveness is.

<p>Nonpharmacological Interventions Addressing Pain, Sleep, and Quality of Life in Children and Adolescents with Primary Headache: A Systematic Review</p>

“…Therefore, the accessibility of local resources could guide the choice of engagement coping strategies in future interventions to treat headache in children. 17 Headache in childhood can be viewed as a biopsychosocial condition because sleep and other stressors can contribute to it. 79 A biopsychosocial perspective adheres to the idea that pain is a result of interactions between nociceptive, sociocultural, behavioral, and cognitive factors.…”

“…14,15 Successful coping with stress contributes to positive headache remission, 16 and cognitive behavioral therapy (CBT) and biofeedback seem to be effective. 17 However, these nonpharmacological interventions are primarily available in specialists' centers, restricting broad access. Many patients worry about the side effects of preventive medications.…”

Behavior management in the field of nursing: A concept analysis

“…In healthcare aspect, behavior management is a method of non‐pharmacology by reinforcing accurate behaviors and extinguishing disruptive or potentially dangerous behaviors . In a review about therapeutic treatment for headache in children and adolescents, Faedda et al.…”

“…From literature review, it can be seen that behavior management is used widely in the healthcare site. Medical term emphasizes behavior management as a non‐pharmacological approach which helps to reduce cost and side effect in treatment . Therefore, many programs of behavior intervention or behavior modification of chronic diseases such as hypertension, diabetes, or kidney disease are conducted in order to manage disease complications and to reduce related problems in terms of society and finance .…”

Quality improvement in neurology: Child neurology quality measure set

“…24 Nonpharmacologic treatment of headache, such as psychological interventions, have been shown to be as effective as first-line therapy, but the frequency of adoption of this as first-line therapy in clinical practice is unknown. 25 …”