Ebeveyn Anksiyetesi ve Çocuklarda Baş Ağrısı ile İlişkisi

Öz

Çalışmada baş ağrısı nedeni ile çocuk nöroloji polikliniklerine başvuran hastaların ebeveynlerinin anksiyete düzeyleri ve bunu etkileyen faktörlerin değerlendirilmesi amaçlanmıştır. Analitik kesitsel bir çalışma gerçekleştirildi. Çalışmaya 154 hasta dahil edildi: Baş ağrısı grubu (n=80), kontrol grubu (n=74). Dahil edilme ve dışlanma kriterlerini karşılayan 7-17 yaş arasındaki hastaların ebeveynlerine, ebeveyn anksiyetesinin değerlendirildiği Durumluk-Sürekli Kaygı Envanteri’nin (State Trait Anxiety Inventory-STAI) ve Aile Değerlendirme Ölçeği yapıldı. Hastaların sosyodemografik verileri ve baş ağrısı özellikleri kaydedildi. Baş ağrısı grubunun yaş ortalaması 13,4 ± 2,7 yıl, kontrol grubunun yaş ortalaması 12,2 ± 3,3 yıldı. Baş ağrısı grubunda kız cinsiyet daha sıktı (%75 & %56,8, p=0,017). Sosyo-demografik özellikler gruplar arasında anlamlı farklılık gösteriyordu. Baş ağrısı olanlarda aile değerlendirme ölçeği total skoru (p=0,046), aile değerlendirme ölçeği alt-skorları arasından, davranış kontrolü (p=0,020) ve genel işlevler (p=0,034) alt skorları kontrol grubuna göre anlamlı derecede daha yüksek saptandı. Bununla birlikte STAI I-II (p=0,509/ p=0,542) ve Aile Değerlendirme Ölçeği alt skorlarından problem çözme (p=0,168), iletişim (p=0,520), roller (0,082), duygusal tepki verebilme (p=0,654) ve gereken ilgiyi gösterme (p=0,943) skorları, gruplar arasında anlamlı farklılık göstermedi. Çocukluk çağı baş ağrıları aile içi patolojinin de bir göstergesi olabileceği için; psikolojik etmenler de göz önünde bulundurularak baş ağrısı olan çocuklar fizik muayene, laboratuvar ve görüntüleme incelemelerinin yanında ailesel etmenler ile beraber değerlendirilmelidir. 

Anahtar Kelimeler

• Çocuk
• Baş Ağrısı
• Ebeveyn Anksiyetesi
• Aile Fonksiyonelliği

Parental Anxiety and Its Relationship with Headache in Children

Öz

We aimed to evaluate the anxiety levels of parents of patients visit to pediatric neurology outpatient clinics due to headaches.

Methods: An analytical cross-sectional study was performed involving 154 participants. Participants were divided into a headache group (n = 80) and a control group (n = 74). The State Trait Anxiety Inventory (STAI) and Family Assessment Scale were used to assess parents' anxiety levels. The mean age of the headache group was 13.4±2.7 years, and the mean age of the control group was 12.2±3.3 years. Females were more common in the headache group compared to the control group (p = 0.017). There were significant differences in the socio-demographic characteristics between the groups. For the headache group, the family assessment scale total score (p = 0.046) from the family assessment scale sub-scores, the behavior control (p = 0.020), and the general functions (p = 0.034) sub-scores were significantly higher than the control group. However, no significant differences were noted with respect to problem solving (p = 0.168), communication (p = 0.520), roles (0.082), emotional reactions (p = 0.654) and showing the required attention level (p=0.943) scores using the STAI I-II (p = 0.509 / p = 0.542). Moreover, the Family Evaluation Scale subscales did not differ significantly between the groups. Childhood headaches can be an indicator of domestic pathology. Accordingly, when considering psychological factors, children with headaches should be evaluated together with familial factors, including physical examinations, laboratory, and imaging studies

Anahtar Kelimeler

• Child
• Headache
• Parent anxiety
• Family functionality

Kaynakça

1. 1. Wöber-Bingöl C. Epidemiology of migraine and headache in children and adolescents. Curr Pain Headache Rep. 2013;17:341.
2. 2. Yılmaz D, Gökkurt D, Tayfur A. Evaluation of Childhood Headache in an Outpatient Pediatric Neurology Clinic. Turkish Journal of Pediatric Disease. 2016:10:162-165.
3. 3. Holden EW, Gladstein J, Trulsen M, et al. Chronic daily headache in children and adolescents. Headache. 1994;34:508–514.
4. 4. Fearon P, Hotopf M. Relation between headache in childhood and physical and psychiatric symptoms in adulthood: National birth cohort study. BMJ. 2001;322:1145.
5. 5. Guidetti V, Galli F, Fabrizi P, et al. Headache and psychiatric comorbidity: Clinical aspects and outcome in an 8-year follow-up study. Cephalalgia. 1998;18:455-462.
6. 6. Spielberger, C.D., R.C. Gorsuch, and R.E. Luschene. Manual for the State-Trait Anxiety invenntory. California: Consulting Psychologists Press; 1970.
7. 7. Öner, N. and A. Le Compte. Durumluk - Sürekli Kaygı Envanteri El Kitabı (in Turkish). İstanbul: Boğaziçi Üniversitesi Yayını; 1983.
8. 8. Epstein NB, Baldwin LM, Bishop DS. The McMaster Family Assessment Device. J Marital Fam Ther. 1983;9:171-180.

9. 9. Bulut, I. Aile değerlendirme ölçeği el kitabı (in Turkish). Ankara: Özgüzeliş Matbaası; 1990.
10. 10. How CH, Chan WS. Headaches in children. Singapore Med J. 2014;55:128–131.
11. 11. Poyrazoğlu HG, Kumandas S, Canpolat M, et al. The prevalence of migraine and tension-type headache among schoolchildren in Kayseri, Turkey: an evaluation of sensitivity and specificity using multivariate analysis. J Child Neurol. 2015;30:889-895.
12. 12. Larsson B, Bille B, Pedersen NL. Genetic influences in headache: a Swedish twin study. Headache. 1995;35:513–519.
13. 13. Ziegler DK, Hur YM, Bouchard TJ Jr, et al. Migraine in twins raised together and apart. Headache. 1998;38:417–422.
14. 14. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84:191–215.
15. 15. Ertem DH, Bingol A, Ugurcan B, et al. The impact of parental attitudes toward children with primary headaches. Clin Child Psychol Psychiatry. 2019;24:767-775.
16. 16. Kaczynski KJ, Claar RL, Lebel AA. Relations between pain characteristics, child and parent variables, and school functioning in adolescents with chronic headache: A comparison of tension-type headache and migraine. Journal of Pediatric Psychology. 2013;38:351–364.
17. 17. Palermo TM, Valrie CR, Karlson CW. Family and parent influences on pediatric chronic pain: a developmental perspective. Am Psychol. 2014;69:142–152.
18. 18. Esposito M, Roccella M, Gallai B, et al. Maternal personality profile of children affected by migraine. Neuropsychiatr Dis Treat. 2013;9:1351–1358.
19. 19. Anttila P, Sourander A, Metsähonkala L, et al. Psychiatric symptoms in children with primary headache. J Am Acad Child Adolesc Psychiatry. 2004;43:412–419.
20. 20. Emiroglu FN, Kurul S, Akay A, et al. Assessment of child neurology outpatients with headache, dizziness and fainting. J Child Neurol. 2004;19: 332–336.
21. 21. Zuckerman B, Stevenson J, Bailey V. Stomachaches and headaches in a community sample of preschool children. Pediatrics. 1987;79:677–682.
22. 22. Galli F, Canzano L, Scalisi TG, et al. Psychiatric disorders and headache familial recurrence: a study on 200 children and their parents. J Headache Pain. 2009;10:187-197.
23. 23. Merikangas KR, Merikangas JR, Angst J. Headache syndromes and psychiatric disorders: association and familial transmission. J Psychiatr Res. 1993;27:197–210.
24. 24. Esposito M, Gallai B, Parisi L, et al. Maternal stress and childhood migraine: a new perspective on management. Neuropsychiatr Dis Treat. 2013;9:351-355.
25. 25. Ostergaard S, Russell MB, Bendsten L, et al. Comparison of first-degree relatives and spouses of people withchronic tension-type headache. BMJ. 1997;3:1092–1093.
26. 26. Abu-Arefeh I, Russell G. Prevalence of headache and migraine in schoolchildren. BMJ. 1994;309:765-769.
27. 27. Kroner-Herwig B, Heinrich M, Morris L. Headache in German children and adolescents:A populationbased epidemiological study. Cephalalgia. 2007;27:519-527.
28. 28. Anttila P, Sourander A, Metsahonkala L et al. Psychiatric symptoms in children with primary headache. J Am Acad Child Adolesc Psychiatry. 2004;43:412-419.
29. 29. Işik U, Topuzoğlu A, Ay P, et al. The prevalence of headache and its association with socioeconomic status among school children in Istanbul, Turkey. Headache. 2009;49:697-703.
30. 30. Ostberg V, Alfven G, Hjern A. Living conditions and psychosomatic complaints in Swedish school children. Acta Paediatr. 2006;95:929-934.