Department of Neurology, Faculty of Medicine, Mersin University, Mersin, Turkiye.
Department of Child and Adolescent Psychiatry, Faculty of Medicine, Mersin University, Mersin, Turkiye.
Turk J Med Sci. 2024 Jul 12;54(5):930-937. doi: 10.55730/1300-0144.5870. eCollection 2024.
BACKGROUND/AIM: Migraine is a prevalent neurological disorder that can lead to disability in children and adolescents. It is frequently accompanied by psychiatric comorbidities, both internalizing and externalizing disorders. While the relationship between migraine and internalizing disorders has been studied, there is limited research on the link between migraine and attention deficit hyperactivity disorder (ADHD).
A total of 280 pediatric headache patients, 107 with externalizing (ADHD) and 173 with internalizing disorders (depression and/or anxiety), were included. The dataset was composed using the Turkish headache database, Mersin Branch. Pain characteristics, associated symptoms, and accompanying comorbidities were evaluated retrospectively.
Two hundred four patients were followed up with episodic migraine (EM) and 76 patients with chronic migraine (CM). One hundred forty-six boys and 134 girls were evaluated, and internalizing disorders were more common in the girls (p < 0.001). It was a much more prominent accompaniment in chronic migraine internalizing disorders (p = 0.038). EM, on the other hand, was more frequent in ADHD. Pain intensity and frequency were greater in those with internalizing disorders (p = 0.007), while photophobia was more prevalent in those with ADHD (OR; 0.555, p = 0.044). Moreover, we observed that individuals with internalizing disorders were predominantly female (p = 0.003) and had a higher mean age (p < 0.001) than those with externalizing disorders.
Internalizing disorders seem to be a risk factor for migraine chronification in pediatric migraine. ADHD is a prototypic externalizing disorder more associated with EM. This outcome provides an opportunity to follow our patients in terms of prognosis and offers us the chance for a better evaluation. Identifying factors that contribute to the chronicity of migraine may lead to better management and reduced disability for migraine sufferers.
背景/目的：偏头痛是一种常见的神经疾病，可导致儿童和青少年残疾。它常伴有精神共病，包括内化和外化障碍。虽然偏头痛与内化障碍之间的关系已经得到研究，但偏头痛与注意缺陷多动障碍（ADHD）之间的联系研究有限。
共纳入 280 例儿科头痛患者，107 例为外化障碍（ADHD），173 例为内化障碍（抑郁和/或焦虑）。该数据集使用土耳其头痛数据库梅尔辛分支机构组成。回顾性评估疼痛特征、伴随症状和伴随共病。
204 例患者为发作性偏头痛（EM），76 例为慢性偏头痛（CM）。共评估了 146 名男孩和 134 名女孩，女孩中内化障碍更为常见（p < 0.001）。在慢性偏头痛内化障碍中，这是一个更为突出的伴随症（p = 0.038）。另一方面，EM 更常见于 ADHD。伴有内化障碍的患者疼痛强度和频率更高（p = 0.007），而伴有 ADHD 的患者畏光更常见（OR；0.555，p = 0.044）。此外，我们观察到，伴有内化障碍的患者主要为女性（p = 0.003），平均年龄较高（p < 0.001），而伴有外化障碍的患者平均年龄较高。
内化障碍似乎是儿科偏头痛慢性化的危险因素。ADHD 是一种典型的外化障碍，与 EM 更相关。这一结果为我们提供了预后随访的机会，并为我们提供了更好的评估机会。确定导致偏头痛慢性化的因素可能会导致偏头痛患者得到更好的管理和减少残疾。
