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Headache in pediatric and neuropsychiatric primary care. A pilot study
R Donfrancesco1, S La Rosa, C Romagnoli
1UO di Neuropsichiatria Infantile Azienda Sanitaria, Firenze.
Insights
Recurrent headaches affect over 17% of children in primary care, with higher rates in child neuropsychiatry. Many cases go unreported, highlighting the need for routine headache screening in pediatric settings.
Area of Science:
- Pediatric Neurology
- Primary Health Care
- Child Psychiatry
Background:
- Headache is a common pediatric complaint.
- Prevalence and clinical features require evaluation in primary care settings.
- Understanding differences across pediatric subspecialties is crucial.
Purpose of the Study:
- Evaluate headache prevalence in pediatric primary care.
- Compare prevalence between child neuropsychiatry and pediatric primary care.
- Identify underreported headache cases and clinical features.
Main Methods:
- Questionnaire administered to consecutive pediatric patients.
- Study involved 259 children aged 5-14 years.
- Data collected over 20 days (neuropsychiatry) and 10 days (pediatrics).
Main Results:
- 17.76% of children experienced recurrent headaches.
- Significantly higher prevalence in neuropsychiatry (22.78%) vs. pediatrics (9.90%).
- 63.04% of headache cases were unreported; 28.26% of children needing preventive therapy did not receive it.
Conclusions:
- Higher headache frequency in child neuropsychiatry may link to psychiatric comorbidities.
- High rates of unreported headaches mirror adult data.
- Routine headache inquiry during pediatric anamnesis is recommended.
Background:
To evaluate the prevalence of headache in primary health care for children (child neuropsychiatry and pediatric primary care), detecting possible differences among areas, showing the number of patients with headache with a clinical significance that had not been communicated to a physician and studying the clinical features of cases.
Methods:
A questionnaire is administered to all consecutive patients of 3 child neuropsychiatrists of a primary health care unit during a period of 20 days and of 2 family pediatricians during a period of 10 days. Data are collected on 259 children, between 5 and 14 years.
Results:
17.76% of examined children have recurrent headache. The percentage is significantly different (p < 0.05) in neuropsychiatry (22.78%) and pediatrics (9.90%). 63.04% of parents with children affected by headache have never reported the disease to a physician and 28.26% of affected children should follow a preventive therapy, but do not. Among all children, 6.56% have migraine and 8.49% have a tension-type headache, according to ICD-10 criteria.
Conclusions:
The higher frequency of headache in child neuropsychiatric primary care is probably due to a comorbidity with psychiatric diseases. The high number of non-reported cases of headache is in agreement with data reported in the literature about adults and suggests that it is important to ask standard questions about headache in the course of the anamnesis in all primary health care for children.
