Behavioral Issues Come to Children with Migraine

A new study in Cephalagia shows that children who have migraine headaches are much more likely than other children to also have behavioral difficulties, including social and attention issues, and anxiety and depression. This is no surprise to me.

Marco Arruda, director of the Glia Institute in São Paulo, Brazil, together with Marcelo Bigal of the Albert Einstein College of Medicine in New York studied 1,856 Brazilian children aged 5 to 11. The authors were studying how children’s behavioural and emotional symptoms correlate with migraine and tension-type headaches.

Children who experience migraine had a much greater overall likelihood of abnormal behavioral scores than controls, especially in social, attention, somatic, anxiety-depressive, and internalizing domains. Children who experience tension-type headaches were affected in the same domains as migraine sufferers, but to a lesser degree.

For children with either migraine (23%) or tension-type headaches (29%), more frequent headaches correlated with increasingly abnormal scores on the behavior scale.  Behavior that was most often seen were those characterized as internalizing — behaviors directed towards the self. 19% of controls were reported to have issues with internalizing behaviors, while over 50% of migraine sufferers were affected. Externalizing behaviors, such as being aggressive and breaking rules, were found to be no more likely among the children with frequent attacks of headache than among the controls.

Other studies have also shown children with migraines are more likely than their peers to have other physical or psychological issues, including anxiety, depression, and attention and hyperactivity problems. However, not as many studies have  explored tension-type headaches in children.

The prevalence rate for children with migraine has been reported to be 3% to over 20% of children as they move from childhood to adolescence.

Clearly this study shows that doctors should be interested in preventative strategies for children who experience both migraines and tension-type headaches so that other behavioral issues that can result can be minimized. Even with reduction of migraine headaches in these children they may still benefit from traditional therapy that can be used to further improve their lives.

Source: Marco A Arruda and Marcelo E Bigal. Behavioral and emotional symptoms and primary headaches in children: A population-based study. Cephalalgia, 2012

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