BACKGROUND: Chronic daily headache (CDH) in children has been documented in general and clinical populations. Comorbid psychological conditions, risk factors and functional outcomes of CDH in children are not well understood.OBJECTIVES: To examine anxiety and depression, associated risk factors and school outcomes in a clinical population of youth with CDH compared with youth with episodic headache (EH).METHODS: Data regarding headache characteristics, anxiety, depression and missed school days were collected from 368 consecutive patients eight to 17 years of age, who presented with primary headache at a specialized pediatric headache centre.RESULTS: A total of 297 patients (81%) were diagnosed with EH and 71 were diagnosed with CDH. Among those with CDH, 78.9% presented with chronic tension-type headache and 21.1% with chronic migraine (CM). Children with CDH had a higher depression score than the standardized reference population. No difference was observed for anxiety or depression scores between children with CDH and those with EH. However, children with CM were more anxious and more depressed than those with chronic tension-type headache. Youth experiencing migraine with aura were three times as likely to have clinically significant anxiety scores. Headache frequency and history were not associated with psychopathological symptoms. Children with CDH missed school more often and for longer periods of time.CONCLUSIONS: These findings document the prevalence of anxiety, depression and school absenteeism in youth with CDH or EH. The present research also extends recent studies examining the impact of aura on psychiatric comorbidity and the debate on CM criteria.

中文翻译：

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患有慢性或发作性头痛的年轻人的焦虑，抑郁和学校旷工

背景：已在一般人群和临床人群中记录了儿童的慢性每日头痛（CDH）。目的：探讨儿童CDH与发作性头痛（EH）青年相比临床人群中的焦虑和抑郁，相关危险因素和学校结局。方法：收集了368名8至17岁的连续头痛患者的头痛特征，焦虑，抑郁和失学日的数据，这些患者在专门的儿科头痛中心表现为原发性头痛。结果：共有297例患者（81％）被诊断为EH，71被诊断为CDH。在患有CDH的患者中，有78.9％的患者表现为慢性紧张型头痛，而21.1％的患者表现为慢性偏头痛（CM）。CDH患儿的抑郁得分高于标准化参考人群。CDH患儿和EH患儿的焦虑或抑郁评分没有差异。但是，与患有慢性紧张型头痛的孩子相比，患有CM的孩子更加焦虑和沮丧。患有偏头痛先兆的年轻人发生临床上显着的焦虑评分的可能性是后者的三倍。头痛的频率和病史与心理病理症状无关。结论：这些发现记录了CDH或EH青年中焦虑，抑郁和学校旷工的患病率。本研究还扩展了最近的研究，研究了先兆对精神病合并症的影响以及关于CM标准的争论。