Emotive and Behavior Problems in Adolescents with Chronic Daily Headache

Introduction: many studies have examined the association between pediatric headache and psychopathology; some of them raised the possibility that headache frequency and severity could be worsened by a reduced psychological ability to mentally process emotions and affects. Aim: The aim of this study was to assess psychopathological comorbidity in adolescents with chronic daily headache (CDH) compared to adolescents with non-chronic headache. Method: We conducted a retrospective study of 42 patients (20 boys and 22 girls; mean age 14) and their mothers, consecutively first seen for therapy-resistant headache in our third-level Child Neuropsichiatry Unit National Neurological Institute “C. Mondino” of Pavia, between November 2012 to January 2014. They were assessed using Parent Child Behaviour Checklist (CBCL) and Youth Self-report (YSR). A detailed history was taken to assess the presence of headache, using criteria defined by International Headache Society (ICHD-3 beta). Results: 21 (50%) of 42 enrolled patients presented a form of Chronic Daily Headache – CDH: ten patients had Chronic Migraine, one Probable Chronic Migraine, eight adolescents Chronic Tension-type Headache and two girls Probable Chronic Tension-type Headache. They had at the YSR higher levels of Somatic Complaints (P=0.006), Thought Problems (P=0.003) and ADHD symptoms (P=0.049). At the CBCL, their mothers reported higher levels of Somatic Complaints (P=0.045) and lower Total Competences (P=0.012). Conclusion: This study confirmed that CDH are associated with a higher level of impairment and with a heavier psychopathological burden. It is possible that the presence of a significant degree of alexythimia in these patients could be associated to the worsening both of headache and of psychopathological aspects.