Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy.
Department of Statistical Sciences, Sapienza University, Rome, Italy.
Cephalalgia. 2020 Nov;40(13):1459-1473. doi: 10.1177/0333102420965139.
The present Italian multicenter study aimed at investigating whether the course of primary headache disorders in children and adolescents was changed during the lockdown necessary to contain the COVID-19 emergency in Italy.
During the lockdown, we submitted an online questionnaire to patients already diagnosed with primary headache disorders. Questions explored the course of headache, daily habits, psychological factors related to COVID-19, general mood and school stress. Answers were transformed into data for statistical analysis. Through a bivariate analysis, the main variables affecting the subjective trend of headache, and intensity and frequency of the attacks were selected. The significant variables were then used for the multivariate analysis.
We collected the answers of 707 patients. In the multivariate analysis, we found that reduction of school effort and anxiety was the main factor explaining the improvement in the subjective trend of headache and the intensity and frequency of the attacks ( < 0.001). The greater the severity of headache, the larger was the clinical improvement ( < 0.001). Disease duration was negatively associated with the improvement ( < 0.001). It is noteworthy that clinical improvement was independent of prophylaxis ( > 0.05), presence of chronic headache disorders ( > 0.05) and geographical area ( > 0.05).
Our study showed that lifestyle modification represents the main factor impacting the course of primary headache disorders in children and adolescents. In particular, reduction in school-related stress during the lockdown was the main factor explaining the general headache improvement in our population.
本意大利多中心研究旨在探讨儿童和青少年原发性头痛障碍的病程是否在意大利为遏制 COVID-19 紧急情况而进行的封锁期间发生改变。
在封锁期间,我们向已经诊断出原发性头痛障碍的患者提交了一份在线问卷。问题探讨了头痛的过程、日常习惯、与 COVID-19 相关的心理因素、一般情绪和学校压力。答案被转化为数据进行统计分析。通过双变量分析,选择了主要影响头痛主观趋势以及发作强度和频率的主要变量。然后使用显著变量进行多变量分析。
我们收集了 707 名患者的答案。在多变量分析中,我们发现减少学校努力和焦虑是解释头痛主观趋势、发作强度和频率改善的主要因素( <0.001)。头痛越严重,临床改善越大( <0.001)。疾病持续时间与改善呈负相关( <0.001)。值得注意的是,临床改善与预防( >0.05)、慢性头痛障碍( >0.05)和地理区域( >0.05)无关。
我们的研究表明,生活方式的改变是影响儿童和青少年原发性头痛障碍病程的主要因素。特别是,封锁期间学校相关压力的减轻是解释我们人群总体头痛改善的主要因素。