Arruda Marco Antônio, Arruda Renato, Landeira-Fernandez J, Anunciação Luis, Bigal Marcelo Eduardo
Department of Neuroscience, Glia Institute, Ribeirão Preto, Brazil.
Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Headache. 2021 Mar;61(3):546-557. doi: 10.1111/head.14078. Epub 2021 Mar 15.
A scarcity of studies on the role of resilience resources (RRs) and vulnerability risk (VR) in children and adolescents with primary headache hampers the development of a risk-resilience model for pediatric headaches.
To examine the extent to which headache frequency and diagnosis are associated with RRs and VR and explore possible predictors of low RRs and high VR in a cross-sectional population-based study in adolescents.
This is a cross-sectional population study conducted in a small city in Brazil (Delfinópolis). Consents and analyzable data were obtained from 339/378 adolescents (89.7%). RRs and VR were assessed using the validated Brazilian version of the Resiliency Scales for Children and Adolescents, completed by the adolescents. Parents filled a structured questionnaire assessing sociodemographic and headache characteristics, as well as the Brazilian-validated version of the Strengths and Difficulties Questionnaire added to the impact supplement to evaluate the adolescent's psychosocial adjustment skills. Teachers completed a structured questionnaire about the students' school performance.
A higher frequency of headache was associated with lower RRs (F = 2.99, p = 0.031) and higher VR (F = 4.05, p = 0.007). Headache diagnosis did not significantly influence the risk of having lower RRs or higher VR. In the exploratory analyses, females (OR 3.07; 95% CI: 1.16-9.3) and individuals with psychosocial adjustment problems (OR 7.5; 95% CI: 2.51-22.4) were predictors of low RRs, and prenatal exposure to tobacco (OR 5.6; 95% CI: 1.57-20.9) was a predictor of high VR in adolescents with primary headache.
The risk of low RRs and high VR was associated with a higher headache frequency, but not with headache diagnosis. These findings may contribute to the development of a risk-resilience model of headaches in the pediatric population and help identify novel targets and develop effective resources for successful interventions.
关于复原力资源（RRs）和脆弱性风险（VR）在原发性头痛儿童和青少年中的作用的研究匮乏，这阻碍了儿童头痛风险 - 复原力模型的发展。
在一项基于人群的青少年横断面研究中，考察头痛频率和诊断与RRs和VR的关联程度，并探索低RRs和高VR的可能预测因素。
这是一项在巴西一个小城市（德尔菲诺波利斯）进行的横断面人群研究。从378名青少年中的339名（89.7%）获得了同意书和可分析数据。RRs和VR使用经过验证的巴西版儿童和青少年复原力量表进行评估，由青少年自行填写。父母填写一份结构化问卷，评估社会人口学和头痛特征，以及添加了影响补充内容的巴西版长处与困难问卷，以评估青少年的心理社会适应技能。教师填写一份关于学生学业成绩的结构化问卷。
头痛频率较高与较低的RRs（F = 2.99，p = 0.031）和较高的VR（F = 4.05，p = 0.007）相关。头痛诊断对RRs较低或VR较高的风险没有显著影响。在探索性分析中，女性（OR 3.07；95% CI：1.16 - 9.3）和有心理社会适应问题的个体（OR 7.5；95% CI：2.51 - 22.4）是低RRs的预测因素，产前接触烟草（OR 5.6；95% CI：1.57 - 20.9）是原发性头痛青少年高VR的预测因素。
低RRs和高VR的风险与较高的头痛频率相关，但与头痛诊断无关。这些发现可能有助于儿童人群头痛风险 - 复原力模型的发展，并有助于确定新的靶点和开发成功干预的有效资源。
