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Abstract
Headache is the most common pain problem in children and adolescents and, in a considerable proportion, a source of suffering and disability. Medical intervention mainly relies on abortive pharmacological agents (analgesics and antimigraine drugs). Psychological therapies aim at the prevention of headache episodes and the modifications of cognitive–emotional and cognitive–behavioral processes influencing pain. Three main forms of therapy have been evaluated in randomized controlled trials and reviewed in meta-analyses: relaxation training, biofeedback and multimodal cognitive–behavioral therapy. So far there is only scarce evidence on hypnosis and acceptance and commitment therapy, although they seem to be promising. Evidence demonstrates that psychological therapies are efficacious, and that clinically relevant improvement is found in approximately 70% of the treated children at follow-up examination. Future research needs to focus on mechanisms of change, and to extend its view of effects induced by therapy beyond headache improvement to indicators of quality of life.
Highlights
Headache is the most common pain problem in children and adolescents and in a considerable proportion, a source of suffering and disability
Medical intervention mainly relies on abortive pharmacological agents
A recent study on German children between 9 and 14 years of age found the prevalence of migraine to be near 9%, Tension-type headache (TTH) was diagnosed in approximately
Summary
Tension-type headache (TTH) and migraine are the most important primary headache syndromes in children and adolescents – that is, headaches that are not secondary to any other medical issue or condition. Tension type headache is more or less diagnosed by excluding migraine symptoms [1] It is defined by low-to-moderate intensity and a dull quality of pain. The number of children with ‘mixed’ or not classifiable headaches can be higher than those with a distinct diagnosis of migraine or TTH. Various epidemiological studies documented that headache is a symptom of high prevalence in children and adolescents, and is the most common type of pain [5,6,7,8]. A recent study on German children between 9 and 14 years of age found the prevalence of migraine to be near 9%, TTH was diagnosed in approximately.
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