Qubty William, Gelfand Amy A
UCSF Department of Neurology, Mission Hall Box 0137, 550 16th Street, 4th Floor, San Francisco, CA, 94158, USA.
Curr Pain Headache Rep. 2016 Dec;20(12):69. doi: 10.1007/s11916-016-0597-1.
It is sometimes assumed that children and adolescents with migraine have a psychiatric or behavioral comorbidity, a belief that can be stigmatizing. This review will examine the recent literature addressing this area to determine if pediatric and adolescent migraineurs are at increased risk for psychiatric comorbidity and to discuss management strategies.
A large systematic review of pediatric and adolescent studies concluded anxiety and depression were not associated with onset of recurrent headaches. Children with increasing migraine frequency have reduced school attendance. Pediatric migraineurs have mildly lower quality of life (QOL) scores than healthy peers but not abnormally low. Finally, children with higher migraine frequency as well as migraineurs with aura were more likely to report suicidal ideation. Migraine is a primary neurologic disorder. Migraine and psychiatric disorders may be comorbid; however, at this time, it can be difficult to clearly delineate some migraine features from psychiatric diagnoses with the current screening tools available. The majority of pediatric migraineurs do not have behavioral comorbidities; however, when such comorbidities occur, they should be addressed and appropriately managed. We need more accurate ways of delineating psychiatric and behavioral comorbidities from the migraine phenotype.
人们有时认为患有偏头痛的儿童和青少年存在精神或行为共病，这种观念可能带有污名化色彩。本综述将审视该领域的近期文献，以确定儿童和青少年偏头痛患者是否有更高的精神共病风险，并讨论管理策略。
一项针对儿童和青少年研究的大型系统综述得出结论，焦虑和抑郁与复发性头痛的发作无关。偏头痛发作频率增加的儿童上学出勤率降低。儿童偏头痛患者的生活质量（QOL）得分略低于健康同龄人，但并非异常低。最后，偏头痛发作频率较高的儿童以及有先兆的偏头痛患者更有可能报告有自杀意念。偏头痛是一种原发性神经系统疾病。偏头痛和精神疾病可能并存；然而，目前使用现有的筛查工具很难将一些偏头痛特征与精神疾病诊断明确区分开来。大多数儿童偏头痛患者没有行为共病；然而，当出现此类共病时，应予以关注并进行适当管理。我们需要更准确的方法来区分偏头痛表型中的精神和行为共病。
