Behavioral management of headache in children and adolescents

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Abstract

Headache is the most frequent neurological symptom and the most prevalent pain in children and adolescents, and constitutes a serious health problem that may lead to impairment in several areas. Psychosocial factors, social environment, life events, school and family stressors are all closely related to headaches. A multidisciplinary strategy is fundamental in addressing headache in children and adolescents. Applying such a strategy can lead to reductions in frequency and severity of the pain, improving significantly the quality of life of these children.

It has been demonstrated that behavioral intervention is highly effective, especially in the treatment of paediatric headache, and can enhance or replace pharmacotherapy, with the advantage of eliminating dangerous side effects and or reducing costs. Behavioral interventions appear to maximize long-term therapeutic benefits and improve compliance with pharmacological treatment, which has proven a significant problem with child and adolescent with headache.

The goal of this review is to examine the existing literature on behavioral therapies used to treat headache in children and adolescents, and so provide an up-to-date picture of what behavioral therapy is and what its effectiveness is.

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Adherence and health care costs

Aurel O Iuga, Maura J. McGuire (2014)

Medication nonadherence is an important public health consideration, affecting health outcomes and overall health care costs. This review considers the most recent developments in adherence research with a focus on the impact of medication adherence on health care costs in the US health system. We describe the magnitude of the nonadherence problem and related costs, with an extensive discussion of the mechanisms underlying the impact of nonadherence on costs. Specifically, we summarize the impact of nonadherence on health care costs in several chronic diseases, such as diabetes and asthma. A brief analysis of existing research study designs, along with suggestions for future research focus, is provided. Finally, given the ongoing changes in the US health care system, we also address some of the most relevant and current trends in health care, including pharmacist-led medication therapy management and electronic (e)-prescribing.

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A new intellectual framework for psychiatry.

E R Kandel (1998)

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.

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Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: an updated meta-analytic review.

Tonya Mizell Palermo, Amanda C de C Williams, Stephen Morley … (2010)

The purpose of this meta-analytic review was to quantify the effects of psychological therapies for the management of chronic pain in youth. Specifically, in this review we updated previous systematic reviews of randomized controlled trials by including new trials, and by adding disability and emotional functioning to pain as treatment outcomes. Electronic searches of the Cochrane Register of Randomised Controlled Trials, MEDLINE, PsycLIT, EMBASE, and the Social Sciences Citation Index were conducted from inception through August 2008. Methodological quality of the studies was assessed, and data extracted on the three primary outcomes of interest. Twenty-five trials including 1247 young people met inclusion criteria and were included in the meta-analysis. Meta-analytic findings demonstrated a large positive effect of psychological intervention on pain reduction at immediate post-treatment and follow-up in youth with headache, abdominal pain, and fibromyalgia. Small and non-significant effects were found for improvements in disability and emotional functioning, although there were limited data on these outcomes available in the included studies. Omnibus cognitive-behavioral therapy, relaxation therapy, and biofeedback all produced significant and positive effects on pain reduction. Studies directly comparing the effects of self-administered versus therapist-administered interventions found similar effects on pain reduction. Psychological therapies result in improvement in pain relief across several different pain conditions in children. Future trials are needed that incorporate non-pain outcome domains, that focus significant therapeutic content on reductions in disability, and that include extended follow-up to better understand maintenance of treatment effects.

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Author and article information

Contributors

Vincenzo Guidetti: 0039064462382 , vincenzo.guidetti@uniroma1.it

Journal

Journal ID (nlm-ta): J Headache Pain

Journal ID (iso-abbrev): J Headache Pain

Title: The Journal of Headache and Pain

Publisher: Springer Milan (Milan )

ISSN (Print): 1129-2369

ISSN (Electronic): 1129-2377

Publication date (Electronic): 5 September 2016

Publication date PMC-release: 5 September 2016

Publication date Collection: 2016

Volume: 17

Issue: 1

Electronic Location Identifier: 80

Affiliations

[1 ]Department of Pediatrics and Child and Adolescent Neuropsychiatry, Sapienza University of Rome, Via dei Sabelli, 108, 00185 Rome, Italy

[2 ]Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy

[3 ]Department of Computer, Control and Management Engineering Antonio Ruberti, Sapienza University of Rome, Rome, Italy

[4 ]Glia Institute, Ribeirão Preto, São Paulo Brazil

Article

Publisher ID: 671

DOI: 10.1186/s10194-016-0671-4

PMC ID: 5011470

PubMed ID: 27596923

SO-VID: 400e78d7-46db-4c8f-a0e4-04b6e250393a

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Date received : 2 July 2016

Date accepted : 20 August 2016

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ScienceOpen disciplines: Anesthesiology & Pain management

Keywords: headache,behavioral therapies,non-pharmacological therapies,cognitive behavioral therapy,children,adolescents

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ScienceOpen disciplines: Anesthesiology & Pain management

Keywords: headache, behavioral therapies, non-pharmacological therapies, cognitive behavioral therapy, children, adolescents

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Behavioral management of headache in children and adolescents

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Creative methods for psychotherapy

Most cited references 98

Adherence and health care costs

A new intellectual framework for psychiatry.

Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: an updated meta-analytic review.

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Cited by 18

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