Children and adolescents with migraine have approximately twice the risk of anxiety or depression compared with youth without migraine, according to a report in the December JAMA Pediatrics.
“One in 10 children and adolescents experience migraine and, across the life span, it is the second most prevalent and disabling disease worldwide,” wrote Katherine Falla, M.D., of the University of Calgary and colleagues. “These results have critical implications for clinical practice, underscoring the need to screen all children and adolescents with migraine for anxiety and depression.”
The researchers searched the medical literature for case-control, cohort, and cross-sectional studies assessing the association between internalizing symptoms and/or disorders (such as anxiety and depression) and migraine in children and adolescents aged 18 years or younger. Eighty studies were included in the final analysis.
The researchers found that children with migraine had double the odds of having anxiety and depressive disorders compared with healthy controls. Moreover, in studies that pooled results for anxiety and depressive disorders, young people with migraine were more than four times as likely to have mixed anxiety and/or depressive disorders, according Falla and colleagues.
In an accompanying editorial, Jessica Hauser Chatterjee, M.D., Ph.D., and Heidi K. Blume, M.D., M.P.H., of the University of Washington School of Medicine noted that combination treatment with fluoxetine and cognitive-behavioral therapy (CBT) is one of the best approaches to the treatment of children with depressive disorders, and that CBT for migraine is one of the most successful treatments for youth with chronic migraine. They added that some youth with headache disorders may need treatment for other psychiatric disorders.
“The work by Falla and colleagues provides strong support for the expansion and increased availability [of] multifaceted and interdisciplinary approaches to migraine treatment,” they wrote.
For related information, see the Psychiatric News article “Psychiatrists Have Role in Managing Pediatric Pain.”
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