title: Emotional problems and prevalence of medication overuse in pediatric chronic daily headache.
abstract: Chronic daily headaches are an increasingly recognized neurologic issue in children. Frequent headaches can be a source of significant disability and family discord with work/school absenteeism. Medication overuse and emotional disorder would significantly impact treatment and progression. This study examined the frequency of emotional and behavioral problems in children and adolescents with chronic daily headache compared with age-related healthy controls. Prevalence of medication overuse in this chronic daily headache group was evaluated. Otherwise healthy children and adolescents with chronic daily headache (according to International Classification of Headache Disorders-II criteria) were enrolled from the Headache Clinic. Healthy controls were prospectively enrolled from physician offices. Multiple psychological rating scales, headache diaries, presence of medication overuse, and disability surveys (Pediatric Migraine Disability Assessment Survey) were completed. A total of 57 healthy controls and 70 patients were studied. The sample consisted largely of females, many of whom (60%) had medication overuse before medical treatment. Headache patients had significantly more symptoms of anxiety, depression, and somatization compared with controls. Patients with chronic daily headache were at higher risk for emotional disorders, and medication overuse was a significant occurrence, suggesting a need for multisystem treatment approach.
authors.affiliation: Department of Pediatrics and Neurology, Ohio State University, College of Medicine, Columbus 43205, USA. pakalnisa@pediatrics.ohio-state.edu
authors.forename: Ann
authors.initials: A
authors.lastname: Pakalnis
authors.forename: Catherine
authors.initials: C
authors.lastname: Butz
authors.forename: Deborah
authors.initials: D
authors.lastname: Splaingard
authors.forename: Donna
authors.initials: D
authors.lastname: Kring
authors.forename: Joanna
authors.initials: J
authors.lastname: Fong
mesh_terms: D000293:Adolescent; D000342:Affective Symptoms / Q000453:epidemiology* / Q000523:psychology; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology / Q000523:psychology; D002908:Chronic Disease; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D020773:Headache Disorders / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects; D009820:Ohio / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects; D013001:Somatoform Disorders / Q000453:epidemiology / Q000523:psychology; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000523:psychology
chemical_list: D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006993:Hypnotics and Sedatives; D009294:Narcotics; D017366:Serotonin Receptor Agonists