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Emotive and Behavior Problems in Adolescents with Chronic Daily Headache

Introduction: Many studies have examined the association between pediatric headache and psychopathology; some of them raised the possibility that headache frequency and severity could be worsened by a reduced psychological ability to mentally process emotions and affects.
Aim: The aim of this study was to assess psychopathological comorbidity in adolescents with chronic daily headache (CDH) compared to adolescents with non-chronic headache.
Method: We conducted a retrospective study of 42 patients (20 boys and 22 girls; mean age 14) and their mothers, consecutively first seen for therapy-resistant headache in our third-level Child Neuropsichiatry Unit National Neurological Institute “C. Mondino” of Pavia, between November 2012 to January 2014. They were assessed using Parent Child Behaviour Checklist (CBCL) and Youth Self-report (YSR). A detailed history was taken to assess the presence of headache, using criteria defined by International Headache Society (ICHD-3 beta).
Results: 21 (50%) of 42 enrolled patients presented a form of Chronic Daily Headache – CDH: ten patients had Chronic Migraine, one Probable Chronic Migraine, eight adolescents Chronic Tension-type Headache and two girls Probable Chronic Tension-type Headache. They had at the YSR higher levels of Somatic Complaints (P=0.006), Thought Problems (P=0.003) and ADHD symptoms (P=0.049). Atthe CBCL,their mothersreported higherlevels of Somatic Complaints (P=0.045) and lower Total Competences (P=0.012).
Conclusion: This study confirmed that CDH are associated with a higher level of impairment and with a heavier psychopathological burden. It is possible that the presence of a significant degree of alexythimia in these patients could be associated to the worsening both of headache and of psychopathological aspects.


Umberto Balottin, Erika Maffioletti, Eliana Antonaci, Martina Maria Mensi and Matteo Chiappedi

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