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Pediatric chronic daily headache associated with school phobia
Mitsue Fujita1, Junko Fujiwara, Takako Maki
1Department of Pediatrics, Tsukuba Gakuen Hospital, Tsukuba, Ibaraki, Japan. mitfujita@tulip.sannet.ne.jp
Summary
Children with chronic daily headache (CDH) and school phobia often have psychiatric disorders and psychosocial issues. Prompt diagnosis and treatment of these comorbidities are crucial for effective management.
Area of Science:
- Pediatric Neurology
- Child Psychiatry
- Behavioral Pediatrics
Background:
- School phobia in children and adolescents can manifest as severe, persistent headaches diagnosed as chronic daily headache (CDH).
- Understanding the specific headache types and comorbidities associated with school phobia is essential for accurate diagnosis and treatment.
Purpose of the Study:
- To compare headache types and psychiatric comorbidities in children with CDH and school phobia versus those with CDH alone.
- To highlight the significance of psychosocial factors and psychiatric disorders in pediatric CDH.
Main Methods:
- A comparative study involving 24 children with CDH and school phobia and 26 children with CDH without school phobia.
- Assessment of headache diagnoses (chronic migraine, chronic tension-type headache) and psychiatric disorders.
Main Results:
- Children with CDH and school phobia showed a significantly higher prevalence of chronic tension-type headache (CTTH) and comorbid CTTH/migraine compared to controls.
- All children with CDH and school phobia presented with psychiatric disorders, including adjustment, anxiety, and conversion disorders, significantly more than the control group.
- Psychiatric disorders were significantly more prevalent in the CDH with school phobia group (100%) compared to the CDH without school phobia group (20%).
Conclusions:
- Children experiencing CDH alongside school phobia frequently exhibit psychosocial challenges and psychiatric disorders.
- Integrated treatment approaches addressing both headaches and underlying psychological and social issues are recommended for this population.
- Attentive diagnosis and management of headaches, psychosocial problems, and psychiatric disorders are vital for children with CDH and school phobia.
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