Psychiatric comorbidity of chronic daily headache: Impact, treatment, outcome, and future studies

Wang, Shuu Jiun; Juang, Kai Dih

doi:10.1007/s11916-002-0071-0

Cited by 30 publications

(17 citation statements)

References 55 publications

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“…Our study confi rmed that hospitalization could play an important role in reducing the emotional mechanisms (on a personal level, within the family and at school) that provoke stress in children and often induce or favour headache attacks [20,27] . If these mechanisms can be interrupted, it is easier for the physician to identify situations of confl ict or tension that may be present; having done this, he/she is better equipped to help the patient to overcome these situations and to alter his/her lifestyle, with lasting benefi ts.…”

Section: Discussionsupporting

confidence: 67%

The Effectiveness of Hospitalization in the Treatment of Paediatric Idiopathic Headache Patients

et al. 2006

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Background: Headache is a disease that has a high social impact in the paediatric as well as in the adult population, often resulting in a significant reduction in the young patient’s quality of life, reflected primarily in a greater number of days off school and increasingly frequent recourse to symptomatic drugs. The idea for this study came from the clinical impression that some paediatric headache patients might benefit more from inpatient than outpatient care. Aim: The aim of our study was to compare the effectiveness of hospitalization to outpatient care of patients with newly diagnosed frequent and disabling headache. Methods: A pragmatic randomized open-label trial was conducted at the Child Neurology Clinic of the University of Pavia, Italy. Children and adolescents with a 2- to 6-month moderate-to-severe migraine or tension-type headache history were randomized to hospital admission or outpatient assessment and followed for 6 months. The efficacy of the two therapeutic strategies was measured by counting the number of responders in each arm. Other end points included the mean frequency and duration of attacks, the number of drug prescriptions taken to control pain, and the number of patients and physicians expressing satisfaction with treatment. Results: The study population included 27 girls and 23 boys aged 8 through 18 years with migraine (23 cases) or tension-type headache (27 cases). Compared to outpatient assessment, hospital admission was correlated to a significant increase in the number of responders: 0 vs. 44% (1 month), 0 vs. 68% (3 months), and 12 vs. 68% (6 months). The mean frequency and duration of attacks were significantly lower in hospitalized patients (p < 0.0001). Hospitalization was correlated with a significant reduction of patients with severe headache (p < 0.005), a reduction of drug use, and a higher number of satisfied patients and physicians (p < 0.05). Logistic regression analysis confirmed the higher responder rate among hospitalized patients after adjusting for age, sex, diagnosis, and headache characteristics or admission. Conclusions: We think hospitalization reduces the emotional mechanisms that provoke stress in children and often induce or favour headache attacks. If these mechanisms can be interrupted, the management of disease may become easier and with enduring benefits.

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Section: Discussionsupporting

confidence: 67%

The Effectiveness of Hospitalization in the Treatment of Paediatric Idiopathic Headache Patients

et al. 2006

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“…First, many studies suggest that psychiatric comorbidity may confer a worse prognosis [32,33]. Second, comorbid psychiatric disorders are associated with higher medical serviceseeking behavior [34]. Third, the presence of a psychiatric disease may provide therapeutic opportunities, such as the ability to treat both TTH and depression with a single medication or with nonpharmacologic approaches that have been found to be helpful for both conditions, such as stress management, biofeedback, and cognitive-behavioral therapy.…”

Section: Comorbidities Of Tension-type Headachementioning

confidence: 99%

Tension-type Headache and Systemic Medical Disorders

Sacco

Ricci

Carolei

2011

Curr Pain Headache Rep

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Tension-type headache (TTH) is the most common form of headache in the general population. Diagnosis of TTH is based merely on clinical features and on careful exclusion of all possible causes of headache. Most of the headaches that present in the context of medical disorders (e.g., hypothyroidism, sleep disorders, and hypertensive crisis) have clinical features overlapping with those of TTH; medical history and specific features of the systemic disorder are usually the clues to establish a correct diagnosis. Some medical disorders may worsen a preexisting TTH, and is also possible the comorbidity of TTH with psychiatric disorders and fibromyalgia.

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“…First, many studies suggest that psychiatric comorbidity may confer a worse prognosis [14,15,45]. Second, comorbid psychiatric disorders are associated with higher medical service-seeking behavior [36]. Third, the presence of psychiatric disease may provide therapeutic opportunities, such as the ability to treat both headache and depression with a single medication, or with nonpharmacologic approaches that have been found to be helpful for both conditions, such as stress management, biofeedback, and cognitive behavioral therapy.…”

Section: Comorbiditymentioning

confidence: 99%