Abstract
We took advantage of a large population study in order to measure child behavior, as captured by the Child Behavior Checklist (CBCL) as a function of headache status in the children and their mothers. Of the target sample, consents and analyzable data were obtained from 1,856 families (85.4 %). Headache diagnoses were defined according to the second edition of the International Classification of Headache Disorders, and behavioral and emotional symptoms were assessed by the validated Brazilian version of the CBCL. We calculated the relative risk of abnormalities in the CBCL domains as a function of headache status in the children, after adjusting by a series of main effect models. Children with migraine were more likely to present abnormal scores in several of the CBCL scales, relative to children without migraine, and maternal migraine status contributed little to the model. However, when the mother had daily headaches, both children with and without migraine had similar CBCL scores. In multivariate analyses, migraine status in the children predicted CBCL scores (p < 0.01). Headache status and headache frequency in the mother did not predict CBCL scores in children with migraine but predicted in children without migraine (p < 0.01). The burden of migraine to the family is complex. Children with migraine are more likely to have behavioral and emotional symptoms than children without migraine. Children without migraine may be affected, in turn, by frequent headaches experienced by their mothers.
Highlights
IntroductionEarly onset cases often have the highest level of biological risk and a more refractory outcomes [1]
For several neurological disorders, early onset cases often have the highest level of biological risk and a more refractory outcomes [1]
Headache diagnoses were defined according to the second edition of the International Classification of Headache Disorders, and behavioral and emotional symptoms were assessed by the validated Brazilian version of the Child Behavior Checklist (CBCL)
Summary
Early onset cases often have the highest level of biological risk and a more refractory outcomes [1]. High frequency headaches [2] and migraine [3] are common in pre-adolescent children, offering a strong opportunity for the development of studies assessing determinants of disease onset and progression. Epidemiological studies show that migraine aggregates within families [5,6,7]. Aggregation seems to increase as a function of disease severity [11], and early onset of migraine in the proband as well as the severity of migraines is associated with higher levels of family aggregation [14]. A recent study has brought some evidence that the headache frequency aggregates in the family [15].
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