Egger H L, Angold A, Costello E J
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
J Am Acad Child Adolesc Psychiatry. 1998 Sep;37(9):951-8. doi: 10.1097/00004583-199809000-00015.
To examine the association between chronic headaches and DSM-III-R-defined psychiatric disorders, including depression, anxiety disorders, conduct disorder, oppositional defiant disorder and attention-deficit hyperactivity disorder, in a population-based sample of children and adolescents.
1,013 children aged 9 to 15 years in the Great Smoky Mountains Study were evaluated annually over a 3-year period using the Child and Adolescent Psychiatric Assessment, a child and parent diagnostic psychiatric interview. Headaches that lasted at least 1 hour and occurred at least once a week during the 3 months prior to the interview were studied.
Girls with depression and anxiety disorders had a significantly greater prevalence of headaches than girls without an internalizing disorder. This association was not found for boys. Conduct disorder was significantly associated with headaches in boys. Each of these associations was constant with age.
This study suggests that a distinct gender difference exists between boys and girls in the associations between headaches and psychopathology. Carroll's theory of dysfunction in central pain regulation as an underlying cause of depression is discussed in relation to the proposed serotonergic dysregulation common to headaches, depression, anxiety, aggression, and pain.
在一个以人群为基础的儿童和青少年样本中，研究慢性头痛与DSM-III-R定义的精神障碍之间的关联，这些精神障碍包括抑郁症、焦虑症、品行障碍、对立违抗障碍和注意力缺陷多动障碍。
在大烟山研究中，对1013名9至15岁的儿童进行了为期3年的年度评估，使用儿童和青少年精神病学评估，这是一种儿童和家长诊断性精神病学访谈。研究在访谈前3个月内持续至少1小时且每周至少发作一次的头痛。
患有抑郁症和焦虑症的女孩头痛患病率明显高于没有内化障碍的女孩。在男孩中未发现这种关联。品行障碍与男孩的头痛显著相关。这些关联中的每一种都与年龄无关。
本研究表明，在头痛与精神病理学之间的关联中，男孩和女孩存在明显的性别差异。讨论了卡罗尔关于中枢疼痛调节功能障碍作为抑郁症潜在原因的理论，该理论与头痛、抑郁症、焦虑症、攻击性和疼痛所共有的拟议血清素能失调有关。
