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A Generalist-Deliverable Bio-Psycho-Social Model for Pediatric Chronic Daily Headache: A 24-Month Retrospective Study
Soken Go1, Natsumi Morishita1, Mika Takeshita1
1Department of Pediatrics and Adolescent Medicine, Tokyo Medical University, Tokyo, Japan.
Pediatric Neurology
|February 3, 2026
Summary
A bio-psycho-social (BPS) model improved chronic daily headache (CDH) in youth, enhancing school attendance and reducing disability. This generalist-delivered approach shows sustained effectiveness without subspecialty care.
Area of Science:
- Pediatric Neurology
- Behavioral Medicine
- Public Health
Background:
- Chronic daily headache (CDH) in youth is a disabling condition often managed with fragmented care.
- Limited access to behavioral services and over-reliance on pharmacologic treatment are common challenges.
- A multifaceted intervention addressing bio-psycho-social factors is needed for effective pediatric CDH management.
Purpose of the Study:
- To evaluate the effectiveness of a generalist-deliverable bio-psycho-social (BPS) management model for pediatric chronic daily headache (CDH).
- To assess the impact of the BPS model on headache frequency, school attendance, and disability.
- To determine if the BPS model is effective in the absence of subspecialty mental health services.
Main Methods:
- Retrospective observational study of 37 pediatric patients with CDH (ICHD-3 criteria).
- All patients received a structured BPS model delivered by general pediatricians, including pharmacologic treatment, psychosocial dialog, and school reintegration.
- Outcomes (headache frequency, school attendance, disability) were assessed at baseline, 6 months, and 24 months.
Main Results:
- Significant reduction in CDH prevalence: 13.5% at 6 months and 5.4% at 24 months.
- Marked improvements in headache frequency, school attendance, and disability scores (P < 0.001).
- Improvements were observed across diagnostic subtypes, highlighting the contribution of nonpharmacologic BPS components.
Conclusions:
- A generalist-delivered BPS model effectively improves pediatric CDH outcomes, including sustained symptom reduction and functional recovery.
- This pragmatic framework supports individualized, function-centered care for pediatric CDH in real-world settings.
- The BPS model demonstrates efficacy even without requiring subspecialty mental health resources.
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