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偏头痛与从青春期到成年期过渡期间其他精神和疼痛障碍的发展。

Migraine and the development of additional psychiatric and pain disorders in the transition from adolescence to adulthood.

机构信息

LMU University Hospital Munich, Dr. von Hauner Children's Hospital, Department for Pediatric Neurology & Developmental Medicine, LMU Center for Munich, Germany Development and Children with Medical Complexity - iSPZ Hauner.

LMU University Hospital Munich, Hospital for Neurology, Munich, Germany.

出版信息

Cephalalgia. 2021 Nov;41(13):1342-1347. doi: 10.1177/03331024211021792. Epub 2021 Jun 23.

Abstract

INTRODUCTION

The transition from childhood to adolescence and from adolescence to adulthood are vulnerable phases in life. In these phases, late or insufficient treatment of diseases may lead to chronification and favor development of additional disorders. In adolescents, migraine often has a highly negative impact on school performance and everyday life. The hypothesis of the present study was that adolescents with migraine have a higher risk for developing additional disorders such as psychiatric disorders or other pain syndromes in the course of the disease.

MATERIALS AND METHODS

In this study, we analyzed health insurance data of 56,597 German adolescents at the age of 15 years in the year 2006. By using the International Classification of Diseases (ICD 10), we determined a group with migraine diagnosis in the year 2006 and a control group without any headache diagnosis in 2006. We then compared both groups regarding the development of additional disorders (based on the ICD 10) during the following 10 years (2007 to 2016).

RESULTS

Adolescents with migraine had a 2.1 fold higher risk than persons without migraine diagnosis to develop an additional affective or mood disorder, a 1.8 fold higher risk to obtain neurotic, stress-related and somatoform disorders, a 1.8 fold higher risk to subsequently suffer from behavioral syndromes, a 1.6 higher risk to get back pain and a 1.5 fold higher risk for irritable bowel syndrome during the next 10 years.

CONCLUSION

Adolescents with migraine are at risk for developing additional disorders later. Considering and addressing the patient's risks and potential medical and psychosocial problems might improve the long-term outcome significantly.

摘要

引言

从儿童期到青春期,再从青春期到成年期,这是人生中比较脆弱的阶段。在这些阶段,疾病的治疗延迟或不充分可能导致慢性化,并促使其他疾病的发展。在青少年中,偏头痛常常对学业成绩和日常生活产生极大的负面影响。本研究的假设是,偏头痛青少年在疾病过程中发生其他疾病(如精神障碍或其他疼痛综合征)的风险更高。

材料与方法

在这项研究中,我们分析了 2006 年 56597 名德国 15 岁青少年的健康保险数据。通过使用国际疾病分类(ICD-10),我们确定了 2006 年患有偏头痛诊断的一组和 2006 年无任何头痛诊断的对照组。然后,我们比较了两组在接下来的 10 年(2007 年至 2016 年)期间发展出其他疾病(基于 ICD-10)的情况。

结果

与无偏头痛诊断的患者相比,患有偏头痛的青少年发生其他情感或情绪障碍的风险高 2.1 倍,发生神经症、应激相关和躯体形式障碍的风险高 1.8 倍,发生行为障碍的风险高 1.8 倍,发生背痛的风险高 1.6 倍,发生肠易激综合征的风险高 1.5 倍。

结论

患有偏头痛的青少年以后发生其他疾病的风险更高。考虑和解决患者的风险以及潜在的医疗和心理社会问题可能会显著改善长期预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e2d/8592111/ef2a2a3dba85/10.1177_03331024211021792-fig1.jpg

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