Abstract
Migraine is one of the most prevalent headache disorders in children and negatively influences their quality of life. Physical, social, and school functioning are negatively affected. Mood changes are common in migraineurs and may happen before, during, or after a migraine headache. Children with migraine are not exempt from mood swings. The majority of mood changes occur during the prodromal phase, manifesting as a psychobiological response, e.g., difficulty thinking, trouble concentrating, irritability, higher or lower energy, confusion, and depression. A bi-directional relationship between migraine and mood has been proposed, but mechanisms are not clear. Collectively, a maladaptive stress response has been suggested to explain the inability to balance homoeostatic changes when facing various stressors. Recognizing mood changes and monitoring mood patterns in children with migraine, for example, by various apps and so-called mood monitors, is valuable for better management. A multidisciplinary intervention has been recommended to reduce migraine disability, improve coping strategies, and reduce chronification risks in children with migraine. Pharmacological and non-pharmacological strategies are both available and effective. Biofeedback, relaxation, and cognitive-behavioral therapy yield positive outcomes in pediatric migraine. Developing healthy lifestyle habits (diet, exercise, sleep) also seems to improve migraine in this population.
Highlights
Children with migraine present mood swings that may happen before, during, or after a migraine headache
The majority of mood changes occur during the prodromal phase, manifesting as a psychobiological response, e.g., difficulty thinking, trouble concentrating, irritability, higher or lower energy, confusion, and depression
Migraines negatively influence the quality of life of affected children
Summary
Children with migraine present mood swings that may happen before, during, or after a migraine headache. A bi-directional relationship between migraine and mood has been proposed, but mechanisms are not clear. The goal of this review is to examine the existing literature on migraine and mood in children and adolescents, and to provide an up-to-date picture of what is known and what is lacking. Identifying research gaps could serve as a starting point for future clinical implications and optimal guidelines. MEDLINE, Web of Science, and Google Scholar databases were searched to gain adequate and efficient coverage. Reference lists of identified papers were judged and used wherever relevant. Additional peer-reviewed literature identified through citations of the key articles was included. The search was unlimited in start time, but limited to the English language
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