Abstract
BackgroundChronic migraine is a condition with gradually increasing prevalence among adolescents which causes severe headaches resulting in functionality loss. Factors contributing to migraine becoming chronic and negatively affecting quality of life in adolescence are still unclear. Parallel with these, we aimed to examine the effect of psychiatric symptoms on headache severity and functionality loss among adolescents with chronic migraine.MethodsWe evaluated features of 50 adolescents who were diagnosed with chronic migraine according to International Classification of Headache Disorders-3 for the first time in their lives by an experienced neurologist. Sociodemographic and clinical data were collected and Pediatric Migraine Disability Assessment Score, Visual Analogue Score and DSM-5 Level 1 Cross-Cutting Symptom Measure Scores (CCSM-5) were evaluated. Semi-structured psychiatric interviews were done to those who scored higher than cut-off scores on CCSM-5. Healthy control group was constituted of cases which had similar age and sex distribution to case group.ResultsMajority of the case group was female (%78). There was a positive correlation between headache severity and computerized tomography history in emergency department. All of the psychiatric symptom scores were significantly higher in case group except for psychotic symptoms; but attention problems and manic symptoms clusters did not have significant difference according to the thresholds of CCSM-5. Receiving a psychiatric diagnosis did not affect frequency, severity or duration of headaches. There were also no relationship between depression/anxiety diagnosis and severity of headache/functionality loss.ConclusionFindings suggest that; more rational treatment methods with lesser functionality loss should be developed by adopting multidisciplinary and prospective approach via psychiatric screening for adolescents with chronic migraine.
Highlights
Headache is the most frequent somatic symptom and major cause of chronic moderately severe pains during adolescence [1,2,3]
Biological, cognitive, emotional and behavioral factors are known to play major roles in occurrence of headaches during adolescence; evaluation of comorbid psychiatric conditions are suggested in order to provide more comprehensive and effective treatment [15, 16]
Positive correlation was found between Visual Analog Scale (VAS) scores and history of computerized tomographies (CTs) during emergency department referrals (p = 0.011, Table 2)
Summary
Headache is the most frequent somatic symptom and major cause of chronic moderately severe pains during adolescence [1,2,3]. Biological, cognitive, emotional and behavioral factors are known to play major roles in occurrence of headaches (especially CM) during adolescence; evaluation of comorbid psychiatric conditions are suggested in order to provide more comprehensive and effective treatment [15, 16]. In this aspect, previous studies have evaluated co-occurrence of psychiatric problems causing emotional dysregulation (such as aggression and irritability) and CM and demonstrated significant relationships in adolescent age group [4, 17, 18]. We aimed to examine the effect of psychiatric symptoms on headache severity and functionality loss among adolescents with chronic migraine
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