The Importance of Stress as a Trigger Factor in Childhood Migraine: An Italian Study (P04.254)

Abstract

Objective: To determine the prevalence of stress reported as a migraine trigger in a pediatric population and to describe the role of different reported trigger factors. We also evaluate the influence on stress of age, gender, headache subtype, psicosocial variables. Background Stress is frequently reported as a headache trigger, both in adult and pediatric sufferes, but is not clearly characterized in pediatric population. Design/Methods: Through a semi-structured interview, parents of 150 pediatric out-patients assessed at San Raffaele Hospital in one year, were asked to provide a detailed clinical history and evaluate the importance and the significance of stress in their children9s headache, specifying the type and frequency of trigger factors on a headache diary. Children suffering from anxiety, depression or any other psychiatric disorder were excluded. Results:72% of patients reported a significant level of stress in determining headache (85% migraine and 13% of tensive-type headache), for a median of 10 days/month on a diary. Different stress trigger factors were recognized in relationship with school (78%), missed sleeping hours (68%), family (25%), travelling (20%), environmental factors (10%), extra-curricular activity(29%), life-events (10%), unidentified trigger factors (20%). Stress resulted more frequent in children between 6 and 11 years old. No difference for sex, family status, parents educational level, living environment, comorbidities.Stress associated symptoms were evident in 50% children. Conclusions: In this monocentric study, we characterized headache triggers reported in 72% by parents as generical “stress factors” in an Italian metropolitan area. Proper individualized counselling of children and their parents is auspicable in order to better copy with stress. Disclosure: Dr. Dalla Libera has nothing to disclose. Dr. Colombo has nothing to disclose. Dr. De Feo has nothing to disclose. Dr. Comi has received personal compensation for activities with Novartis, Teva Neuroscience, Sanofi-Aventis Pharmaceuticals, Inc., Merck Serono, Bayer Schering, and Biogen Dompe.