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Childhood chronic daily headache: a biopsychosocial perspective

S S Seshia1, D F Phillips, C L von Baeyer

  • 1Department of Pediatrics, Royal University Hospital and University of Saskatchewan, Saskatoon, Canada.

Developmental Medicine and Child Neurology
|July 10, 2008
PubMed

Insights

Chronic daily headache (CDH) in pediatric patients often arises from prior headaches and co-occurring conditions like anxiety or mood disorders. A biopsychosocial approach is recommended for better clinical management of pediatric CDH.

Area of Science:

  • Pediatric Neurology
  • Clinical Observations
  • Headache Medicine

Background:

  • Chronic daily headache (CDH) is a significant concern in children and adolescents.
  • Understanding the clinical characteristics of CDH in this population is crucial for effective management.

Purpose of the Study:

  • To present clinical observations of chronic daily headache in pediatric patients.
  • To explore the subtypes, comorbidities, and contributing factors of CDH in children and adolescents.

Main Methods:

  • An observational study involving 70 pediatric patients (<=18 years) with CDH.
  • Prospective data collection from February 2004 to July 2006 at a Pediatric Headache Clinic.
  • Standardized data sheets and definitions were utilized, with follow-up data available to February 2007.

Main Results:

  • 77% of participants experienced recurrent headaches prior to developing CDH.
  • The most frequent CDH subtype was comorbid chronic migraine and chronic tension-type headache (53%).
  • Anxiety disorders (17%) and mood disorders (15%) were common comorbidities, with stressors identified in 63% of cases.

Conclusions:

  • CDH in children and adolescents is often linked to prior headache history and psychological comorbidities.
  • A biopsychosocial model is suggested for understanding and managing pediatric CDH, rather than a purely biomedical one.
  • Improvements in classification are needed to enhance clinical utility for CDH in pediatric populations.

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