title: Alexithymic characteristics in pediatric patients with primary headache: a comparison between migraine and tension-type headache.
abstract: BACKGROUND
  Alexithymia is a personality construct characterized by difficulties in verbal emotional expression and a limited ability to use one's imagination. Evidence of alexithymic characteristics was found in adults suffering from headache, while little is known about children. The aim of this study was to establish the prevalence of alexithymia in two different subgroups of children and adolescents suffering from primary headache. We also looked for correlation between alexithymia in children and in their mothers.
  
  
  METHODS
  This study involved 89 participants: 47 (11 males, 36 females, aged 8 to 17 years) suffering from tension-type headache (TTH), and 42 (18 males, 24 females, aged 8 to 17 years) suffering from migraine (M), based on the International Classification of Headache Disorders (ICHD 2013). A control group of 32 headache-free subjects (26 females and 6 males, aged 8 to 17 years) was also considered. Two questionnaires were administered to measure alexithymia: the Alexithymia Questionnaire for Children to young patients and controls, and the Toronto Alexithymia Scale (TAS-20) to the mothers.
  
  
  RESULTS
  Higher rates of alexithymia emerged in the TTH group compared to the M group. In particular, TTH sufferers had difficulty identifying their feelings. The mothers of children with headaches didn't score higher in alexithymia compared to other mothers. In the M and in the control group, there was a significant correlation between the rates of alexithymia in young people and in their mothers.
  
  
  CONCLUSIONS
  To date no other study has investigated alexithymia in subgroups of primary headaches in developmental age. Our results suggest that patients suffering from TTH are more alexithymic than M patients. This pave the way to etiopathogenetic and clinical considerations, calling for a comprehensive and multidisciplinary approach to tackle the problem of headache.
authors.affiliation: Department of Woman and Child Health, University of Padova, Padova, Italy. michela.gatta@unipd.it.
authors.forename: M
authors.initials: M
authors.lastname: Gatta
authors.affiliation: Department of Child and Adolescent Neuropsychiatry, University of Palermo, Palermo, Italy. cspitaleri@hotmail.it.
authors.forename: C
authors.initials: C
authors.lastname: Spitaleri
authors.affiliation: Child Neuropsychiatry Unit, C. Mondino National Neurological Institute, Pavia, Italy. umberto.balottin@unipv.it.|Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy. umberto.balottin@unipv.it.
authors.forename: U
authors.initials: U
authors.lastname: Balottin
authors.affiliation: Department of General Psychology, University of Padova, Padova, Italy. andrea.spoto@unipd.it.
authors.forename: A
authors.initials: A
authors.lastname: Spoto
authors.affiliation: Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy. laura.balottin@libero.it.
authors.forename: L
authors.initials: L
authors.lastname: Balottin
authors.affiliation: Department of Child and Adolescent Neuropsychiatry, University of Palermo, Palermo, Italy. salvatore.mangano@unipa.it.
authors.forename: S
authors.initials: S
authors.lastname: Mangano
authors.affiliation: Department of Woman and Child Health, University of Padova, Padova, Italy. pierantonio.battistella@unipd.it.
authors.forename: P A
authors.initials: PA
authors.lastname: Battistella
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000453:epidemiology*; D019964:Mood Disorders / Q000453:epidemiology*; D009035:Mothers; D015995:Prevalence; D011795:Surveys and Questionnaires; D018781:Tension-Type Headache / Q000453:epidemiology*
keywords: Alexithymia; Alexithymia Questionnaire for Children; Migraine; Tension-type headache; Toronto Alexithymia Scale