Migren Tipi Baş Ağrısı Olan Çocuklarda Anksiyete Düzeyi Artmakta mıdır?

Year 2020, Volume: 25 Issue: 1, 51 - 55, 15.01.2020

Elif Karatoprak Selin Yıldız

https://doi.org/10.21673/anadoluklin.613608

Abstract

Amaç: Migren
çocuklarda sık görülen primer baş ağrısı nedenlerindendir. Migren hastalarında psikiyatrik
komorbidite de bildirilmektedir.Bu çalışmada migren tanısı alan çocukların ve migrensiz gönüllülerin anksiyete düzeyleri arasında anlamlı bir fark olup olmadığını araştırmak amaçlanmıştır.

Gereç
ve Yöntemler: Çocuk nöroloji polikliniğimizde prospektif,
vaka kontrollü, kesitsel bir çalışma gerçekleştirildi. Çalışmaya baş ağrısı şikayetiyle
başvurup migren tanısı alan çocuklar (çalışma
grubu) ile başka nedenlerle başvurup herhangi bir kronik hastalık saptanmayan gönüllü
çocuklar (kontrol grubu) dahil edildi. İki
gruba da Çocuklarda Anksiyete Bozukluklarını Tarama Ölçeği (ÇATÖ)
uygulandı ve aldıkları puanlar karşılaştırıldı. Ayrıca migrenli hastaların ÇATÖ
puanı ile migren atak sıklığı ve hastalık süresi arasındaki ilişki incelendi.

Bulgular: Çalışma
grubunda 83 çocuk (29 erkek, 54
kız) vardı ve yaş ortalaması 13,23±2,3 yıldı. Kontrol grubunda 80 çocuk
(36 erkek, 44 kız) vardı ve yaş ortalaması 13,97±2,6 yıl idi. İki grup arasında
yaş ve cinsiyet açısından istatistiksel olarak anlamlı fark saptanmadı. Çalışma
ve kontrol grubu ortalama ÇATÖ puanları sırasıyla 26,4±11,9 ve 26,6±12,4 olarak
tespit edildi ve istatistiksel olarak anlamlı fark bulunmadı (p=0,93). Çalışma
grubundan 46 (%55,4), kontrol grubundan 41 (%51,2) çocuğun ÇATÖ puanı ≥25 (patolojik
eşik değer) idi; kaygı bozukluğu riski iki grup için de yüksekti. Çalışma
grubunda hastalığın süresi ile ÇATÖ puanı arasında korelasyon saptanmadı (r=0,15,
p=0,17), fakat atak sıklığı ile ÇATÖ puanı arasında pozitif korelasyon saptandı
(r=0,35, p=0,001).

Tartışma
ve Sonuç: Migrenli ve migrensiz çocukların anksiyete düzeyleri arasında
anlamlı bir fark saptamamış olsak da, atak
sıklığı arttıkça anksiyete düzeyi yükselebileceği için migrenli hastaların
anksiyete açısından yakından takibinin yararlı olacağı kanaatindeyiz. 

Keywords

migren, pediatri, anksiyete

Do Children with Migraine-type Headache Exhibit Increased Levels of Anxiety?

Abstract

Aim: Migraine is a common cause of primary headache in
children. Psychiatric comorbidity has also been reported in migraine patients. In
this study, we aimed to investigate whether there was a significant difference
between the anxiety levels of children diagnosed with migraine and volunteer
children without migraine.

Materials and Methods: We carried out a prospective, case-controlled,
cross-sectional study in our pediatric neurology outpatient clinic. The study
included children who presented with headache and were diagnosed with migraine (the
study group) and volunteer children who presented with other complaints and were
found to have no chronic disease (the control group). Both groups were assessed
with the Screen for Child Anxiety Related Emotional Disorders (SCARED) and
their scores were compared. We also investigated the relationship between the SCARED
scores and migraine attack frequency and illness time.

Results: The study group consisted of 83 children (29 boys, 54 girls) with a
mean age of 13.23±2.3 years and the control group 80 children (36 boys, 44
girls) with a mean age of 13.97±2.6 years. No statistically significant
difference was found between the two groups in terms of age and sex. The mean SCARED scores of the study and control
groups were 26.4±11.9 and 26.6±12.4,
respectively; and there was no significant difference (p=0.93). Forty-six
children (55.4%) from the study group and 41 (51.2%) from the control
group had a SCARED score  ≥25 (the pathological cut-off value); the risk of an anxiety
disorder was high for both groups. For the study group, we found that the
SCARED score was not correlated with illness time (r=0.15, p=0.17), but had a
positive correlation with attack frequency (r=0.35, p=0.001).

Discussion and Conclusion: Although we found no significant difference between
the anxiety levels of the children with and without migraine, we think that close
follow-up for anxiety would be beneficial in migraine patients because the patient’s
level of anxiety could increase with migraine attack frequency. 

Keywords

pediatrics, anxiety, migraine

References

• 1. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
• 2. Abu-Arafeh I, Razak S, Sivaraman B, Graham C. Prevalence of headache and migraine in children and adolescents: a systematic review of population-based studies. Dev Med Child Neurol. 2010;52(12):1088-97.
• 3. Ozge A, Bugdayci R, Sasmaz T, Kaleagasi H, Kurt O, Karakelle A, et al. The sensitivity and specificity of the case definition criteria in diagnosis of headache: a school-based epidemiological study of 5562 children in Mersin. Cephalalgia. 2002;22(10):791-8.
• 4. Machnes-Maayan D, Elazar M, Apter A, Zeharia A, Krispin O, Eidlitz-Markus T. Screening for psychiatric comorbidity in children with recurrent headache or recurrent abdominal pain. Pediatr Neurol. 2014;50(1):49-56.
• 5. Wang SJ, Juang KD. Psychiatric comorbidity of chronic daily headache: impact, treatment, outcome, and future studies. Curr Pain Headache Rep. 2002;6(6):505-10.
• 6. O'Brien HL, Slater SK. Comorbid Psychological Conditions in Pediatric Headache. Semin Pediatr Neurol. 2016;23(1):68-70.
• 7. Birmaher B, Khetarpal S, Brent D, Cully M, Balach L, Kaufman J, et al. The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics. J Am Acad Child Adolesc Psychiatry. 1997;36(4):545-53.
• 8. FK Ç. Çocuklarda Anksiyete Bozukluklarını Tarama Ölçeği geçerlik ve güvenirlik çalışması. Kocaeli: Kocaeli Üniversitesi, Tıp Fakültesi; 2004.
• 9. Bruijn J, Locher H, Passchier J, Dijkstra N, Arts WF. Psychopathology in children and adolescents with migraine in clinical studies: a systematic review. Pediatrics. 2010;126(2):323-32.
• 10. Güler G, Meryem Ozlem K, Fevziye T, Aynur Ö, Bahar T. The high level of psychiatric disorders associated with migraine or tension-type headache in adolescents. Journal of Neurological Sciences (Turkish). 2017;34 (4):312-21.
• 11. Kandemir G, Hesapcioglu ST, Kurt ANC. What Are the Psychosocial Factors Associated With Migraine in the Child? Comorbid Psychiatric Disorders, Family Functioning, Parenting Style, or Mom's Psychiatric Symptoms? J Child Neurol. 2018;33(2):174-81.
• 12. Oztop DB, Tasdelen BI, PoyrazogLu HG, Ozsoy S, Yilmaz R, Sahin N, et al. Assessment of Psychopathology and Quality of Life in Children and Adolescents With Migraine. J Child Neurol. 2016;31(7):837-42.
• 13. Heckman BD, Holroyd KA, Himawan L, O'Donnell FJ, Tietjen G, Utley C, et al. Do psychiatric comorbidities influence headache treatment outcomes? Results of a naturalistic longitudinal treatment study. Pain. 2009;146(1-2):56-64.
• 14. Slater SK, Kashikar-Zuck SM, Allen JR, LeCates SL, Kabbouche MA, O'Brien HL, et al. Psychiatric comorbidity in pediatric chronic daily headache. Cephalalgia. 2012;32(15):1116-22.
• 15. Guidetti V, Galli F. Recent development in paediatric headache. Curr Opin Neurol. 2001;14(3):335-40.
• 16. Just U, Oelkers R, Bender S, Parzer P, Ebinger F, Weisbrod M, et al. Emotional and behavioural problems in children and adolescents with primary headache. Cephalalgia. 2003;23(3):206-13.
• 17. Fielding J, Young S, Martin PR, Waters AM. Headache symptoms consistent with migraine and tension-type headaches in children with anxiety disorders. J Anxiety Disord. 2016;40:67-74.
• 18. Jette N, Patten S, Williams J, Becker W, Wiebe S. Comorbidity of migraine and psychiatric disorders--a national population-based study. Headache. 2008;48(4):501-16.
• 19. Anttila P, Sourander A, Metsahonkala L, Aromaa M, Helenius H, Sillanpaa M. Psychiatric symptoms in children with primary headache. J Am Acad Child Adolesc Psychiatry. 2004;43(4):412-9.