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Essential headaches in developmental age: What is changed before, during and after the lockdown for COVID-19
Alice Bonuccelli1, Greta Depietri2, Tommaso Baldaccini2
1PediatricNeurology, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy.
Insights
The COVID-19 lockdown significantly impacted children's essential headaches, increasing video terminal use and decreasing physical activity. Individual responses varied, but lifestyle changes were consistent across patients.
Area of Science:
- Pediatric Neurology
- Public Health
- Child Psychology
Background:
- Essential headaches significantly affect children's quality of life.
- Headache triggers (stress, screen time, fatigue) and comorbidities (anxiety, depression, sleep issues) were amplified by the COVID-19 pandemic.
- The pandemic created a highly stressful environment for children, exacerbating existing health challenges.
Purpose of the Study:
- To investigate the impact of the COVID-19 lockdown on children's headaches, lifestyle, and mental health.
- To analyze changes in headache patterns, triggers, and comorbidities before, during, and after the lockdown.
- To identify differences in these aspects based on age, gender, and pre-lockdown headache status.
Main Methods:
- A study involving 90 pediatric patients with primary headaches at the AOUP Neuropediatrics Clinic (January 2018-March 2022).
- Participants completed a 21-question survey assessing headache, lifestyle, and mental health across three periods: pre-lockdown, during lockdown, and post-lockdown.
- Statistical analysis was performed using SPSS, including Cohen's K-Concordance Test for trend analysis.
Main Results:
- While headache characteristics showed poor concordance in trends, modest to moderate concordance was observed for frequency, type (migraine/tension), and acute analgesic use.
- The lockdown significantly decreased sports participation (physical activity) and increased video terminal usage.
- A notable prevalence of adolescents (56.7%) and early headache onset (77.7% before age 10) was recorded.
Conclusions:
- The COVID-19 pandemic and lockdown elicited varied individual responses regarding headaches, lifestyle, and psychological well-being.
- Physical activity levels and video terminal use were consistently and significantly modified by the pandemic situation, irrespective of individual subjective influences.
- Understanding these pandemic-induced shifts is crucial for managing pediatric headaches and associated factors.
Introduction:
Essential headache is one of the main causes of pain in children, and has an important impact on their quality of life. In children with essential headaches play an important role in both triggers like stress, excessive use of video terminals, or physical fatigue but also comorbidities like anxiety, depression, and sleep disturbances. CoViD-19 Pandemic was very stressful, especially for children, and amplified all headache triggers and comorbidities.
Study Objective:
In this work, we studied the aspects concerning the headache,lifestyle, habits, and mental health of children before, during, and after the lockdown and the differences between some categories (selected by age, gender, and headache status before the lockdown).
Methods:
This study was conducted on 90 patients with primary headaches followed at the AOUP Neuropediatrics Clinic from January 2018 to March 2022. Participants answered a questionnaire of 21 questions. For every question, the answer was divided into three periods: before, during, or after the lockdown. All dates have been converted and inserted into a database and we used SPSS technology for statistical analysis.
Results:
In our study, 51,1% were females and 48,9% were males and there was a prevalence of adolescents (56,7%) compared to children from 5 to 11 years (43,3%). Regarding the headache onset, 77,7% of patients started to suffer from headaches before 10 years, moreover, 68,9% had familiarity with the headache. Using Cohen's K- Concordance Test, we performed a Concordance Analysis, studying the questions in the three periods above mentioned: considering headache characteristics there is poor concordance about the trend of headache; modest concordance (K: 0,2-0,4) about the frequency and the type (migraine or tension headache); moderate concordance (K: 0,41-0,61) about the acute use of analgesic. Analyzing lifestyle the lockdown had a significant impact on sports (practiced much less) and on the use of video terminals (used much more).
Conclusion:
The pandemic and lockdown aren't events that led to strong and unidirectional responses in patients, there is great variability in the answers about headache, lifestyle, and psychology, and each patient had individualized reactions. However, these considerations are not applied to physical activity and the use of video terminals, because both have been inevitably modified by the pandemic situations and so were not affected by subjective influence.
