Syed Sifat E, Mullick Mohammad S I
Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Brain Behav. 2025 Jun;15(6):e70599. doi: 10.1002/brb3.70599.
Headaches in pediatric populations are increasingly recognized as being associated with psychiatric disorders, predicting poor clinical outcomes. Despite global evidence, data from South Asia, particularly Bangladesh, remain sparse, limiting region-specific insights into this comorbidity.
This descriptive, cross-sectional study was conducted in the Pediatric Neurology Departments of two tertiary care hospitals in Dhaka, Bangladesh, between July 2019 and March 2020. A total of 151 children and adolescents were assessed using the International Classification of Headache Disorders (ICHD-III beta version) for headache classification and the validated Bangla version of the Development and Well-Being Assessment (DAWBA) for psychiatric diagnoses.
Tension-type headache was the most common type of headache (62.9%), followed by migraines (16.6%). Psychiatric co-morbidities were identified in 39.7% of participants, with 13.2% presenting with multiple psychiatric disorders. Anxiety disorders (19.9%) and depressive disorders (12.6%) were the most prevalent. Children experiencing frequent headaches had significantly higher rates of psychiatric co-morbidities (p = 0.020, 95% CI: 0.000-0.042). Logistic regression analysis revealed headache frequency as a minor but noteworthy predictor of psychiatric co-morbidity (OR = 1.06, 95% CI: 1.016-1.093).
This study highlights a high burden of psychiatric disorders among children and adolescents with headaches in Bangladesh, emphasizing the importance of psychiatric screening and multidisciplinary management approaches for pediatric headache. The findings provide valuable regional data and reinforce the need for pediatrician-psychiatrist collaboration to improve outcomes.
儿科人群中的头痛越来越被认为与精神障碍有关，预示着临床预后不良。尽管有全球范围内的证据，但来自南亚的数据，尤其是孟加拉国的数据仍然稀少，限制了对这种共病的区域特异性见解。
这项描述性横断面研究于2019年7月至2020年3月在孟加拉国达卡的两家三级护理医院的儿科神经科进行。共有151名儿童和青少年使用《国际头痛疾病分类》（ICHD-III beta版）进行头痛分类，并使用经过验证的孟加拉语版《发育与幸福感评估》（DAWBA）进行精神疾病诊断。
紧张型头痛是最常见的头痛类型（62.9%），其次是偏头痛（16.6%）。39.7%的参与者被确定存在精神共病，13.2%的参与者患有多种精神疾病。焦虑症（19.9%）和抑郁症（12.6%）最为普遍。经常头痛的儿童精神共病率显著更高（p = 0.020，95% CI：0.000 - 0.042）。逻辑回归分析显示头痛频率是精神共病的一个次要但值得注意的预测因素（OR = 1.06，95% CI：1.016 - 1.093）。
本研究强调了孟加拉国头痛儿童和青少年中精神疾病的高负担，强调了儿科头痛的精神筛查和多学科管理方法的重要性。这些发现提供了有价值的区域数据，并强化了儿科医生与精神科医生合作以改善预后的必要性。
