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Zaranek L, Sobe H, Richter M, Hübler A, Berner R, von der Hagen M, Koch T, Sabatowski R, Klimova A, Goßrau G. [Gender-specific results of the Dresden children and adolescents headache program DreKiP]. Schmerz 2024; 38:107-117. [PMID: 37737282 PMCID: PMC10959813 DOI: 10.1007/s00482-023-00756-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Girls and women are more frequently affected by headache than boys and men. The influence of gender on the effectiveness of headache therapies has so far been hardly investigated. We examined gender differences in the outpatient multimodal Dresden Child and Adolescent Headache Program DreKiP. METHODS We treated 140 patients with primary headache in a 15-hour structured group program. At baseline (T0) and six (T1) and twelve months (T2) after the end of the program, data on headache-related limitation of daily activities (PedMIDAS) as well as headache frequency, intensity, and pain-related disability (P-PDI) were collected. Retrospectively, these data were analyzed separately for girls and boys. RESULTS For 91 patients (9-19 years, median = 15; 71.4 % female) data were available for at least two measurement time points. Girls showed significantly higher headache frequency than boys at all time points (median headache days/last three months at T0: ♀ 43, ♂ 20; T1: ♀ 32, ♂ 12; T2: ♀ 28, ♂ 9) as well as numerically higher headache-related limitation of daily life. There were significant effects over time with a decrease in headache frequency (F (2.88) = 5.862; p = 0.004) and improvement in daily functioning (F (2.92) = 5.340; p = 0.006). There was no gender-specific treatment response. DISCUSSION The DreKiP therapy shows effects in girls and boys with primary headache. Higher headache frequencies and everyday life restrictions in girls may have hormonal but also psychosocial causes and should be addressed in educational measures.
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Affiliation(s)
- Laura Zaranek
- Klinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Hanna Sobe
- UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - Matthias Richter
- Klinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
- UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - Anke Hübler
- UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
- Klinik für Anästhesiologie und Intensivtherapie, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Reinhard Berner
- Klinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Maja von der Hagen
- Klinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
- Abteilung Neuropädiatrie, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Thea Koch
- Klinik für Anästhesiologie und Intensivtherapie, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Rainer Sabatowski
- UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
- Klinik für Anästhesiologie und Intensivtherapie, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Anna Klimova
- NCT Partner Site Dresden, Institut für Medizinische Informatik und Biometrie, Medizinische Fakultät "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Gudrun Goßrau
- UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
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2
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Sharma A, Khurana P, Venkatraman A, Gupta M. Subsume Pediatric Headaches in Psychiatric Disorders? Critiques on Delphic Nosology, Diagnostic Conundrums, and Variability in the Interventions. Curr Pain Headache Rep 2024:10.1007/s11916-024-01225-7. [PMID: 38367199 DOI: 10.1007/s11916-024-01225-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE OF REVIEW Tension-type headache (TTH) continues to be the most prevalent type of headache across all age groups worldwide, and the global burden of migraine and TTH together account for 7% of all-cause years lived with disability (YLDs). TTH has been shown to have a prevalence of up to 80% in several studies and presents a wide range and high variability in clinical settings. The aim of this review is to identify gaps in diagnostics, nosology, and variability in the treatment of children and adolescents who present with headaches without an identifiable etiology. RECENT FINDINGS Migraine and TTH have been debated to have more similarities than distinctions, increasing chances of misdiagnosis and leading to significant cases diagnosed as probable TTH or probable migraine. The lack of specificity and sensitivity for TTH classification often leads to the diagnosis being made by negating associated migraine symptoms. Although pathology is not well understood, some studies have suggested a neurological basis for TTH, in need of further validation. Some research indicates that nitric oxide signaling plays an integral part in the pain mechanisms related to TTH. Analgesics and non-steroidal anti-inflammatories are usually the first lines of treatment for children with recurring headaches, and additional treatment options include medication and behavioral therapies. With high prevalence and socioeconomic burden among children and adolescents, it's essential to further study Tension-type headaches and secondary headaches without known cause and potential interventions. Treatment studies involving randomized controlled trials are also needed to test the efficacy of various treatments further.
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Affiliation(s)
- Aditya Sharma
- Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA
| | - Priyal Khurana
- Department of Psychology, Christ University, Delhi, NCR, India
| | - Akila Venkatraman
- Department of Pediatric Neurology, Geisinger Health System, Danville, PA, USA
| | - Mayank Gupta
- Southwood Psychiatric Hospital, Pittsburgh, PA, USA.
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3
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Risk factors for Meniere disease: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2022; 279:5485-5496. [PMID: 35794275 DOI: 10.1007/s00405-022-07505-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/11/2022] [Indexed: 02/05/2023]
Abstract
PURPOSE To summarized the latest evidence of risk factors for developing MD. METHODS We searched Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, CBM, VIP, WanFANG, and CNKI, and ClinicalTrials.gov. till June 2021 for cohort and case-control studies investigating risk factors for MD. The exposure group was participants with a clinical diagnosis of MD which was made according to the diagnostic scale of the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), the control group was participants without MD. The outcome was determined by incidence or prognostic of MD. Paired reviewers independently screened citations, assessed bias risk of included studies using the Newcastle-Ottawa Scale. Odds ratios (OR), hazard ratios(HR), relative risk(RR) and 95% confidence interval (CI) were calculated for dichotomous data. The statistical analyses were carried out with the use of Review Manager 5.3. The level of statistical heterogeneity for pooled data were assessed by using I2 statistics and Q-test. RESULTS 768 abstracts and articles were identified by our search, of which 25 studies (n = 1, 471, 944) were included. There were 18 cohort studies, 7 case-control studies. Three distinct subgroups (age, sex, sleep) were identified. There were a total of two studies involving age, two studies involving gender and two studies involving sleep disorder. High to moderate methodological quality established that age [hazard ratios (HR) 2.21, 95% CI 1.85-2.65, I2 = 0%] and sleep disorder[HR 1.68, 95% CI 1.47-1.93, I2 = 0%] were risk factors for MD. While there was little evidence showing that sex was not a risk factor for MD [HR 1.61, 95% CI 0.91-2.84, I2 = 74%]. CONCLUSION The current evidence supports the suggestion that age and sleep disorder are risk factors for MD. Sex, gene, and hypothyroidism are tentative risk factors but conflicting/inconclusive results. FUNDING No external funding. REGISTRATION CRD42021248199 (Prospero).
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Sobe H, Richter M, Berner R, von der Hagen M, Hähner A, Röder I, Koch T, Sabatowski R, Klimova A, Gossrau G. Functional improvement in children and adolescents with primary headache after an interdisciplinary multimodal therapy program: the DreKiP study. J Headache Pain 2022; 23:109. [PMID: 36008766 PMCID: PMC9404663 DOI: 10.1186/s10194-022-01481-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND More than 2/3 of children and adolescents in Germany regularly suffer from headaches. Headache-related limitations in everyday life, school drop-out and educational impairment are common. Structured therapy programs for young headache patients are widely missing. METHODS One hundred eleven patients with frequent migraine and/or tension type headache were treated in a 15 hour group program in afternoons, parallel with school, parents received 7 hours of therapy. At the beginning of the program (T0), 6 (T1) and 12 months (T2) after completion, data on headache related disability (PedMidas), headache frequency, intensity, and pediatric pain disability score (PPDI) were prospectively collected to investigate the effects of the therapy. RESULTS Seventy-five patients (9-19 years, median = 14; 66.7% female) and their parents provided patient reported outcome measures showing at T1 (65 patients) and T2 (47 patients) reduced headache frequency (last 3 months headache days median T0: 30 days; T1: 18 days, reduction of median 12 days since T0; T2: 13 days, reduction of median 17 days since T0). Linear mixed models revealed significant reduction (T0/T1 p = 0,002; T0/T2 p = 0,001). Reduced headache disability has been reported at T1 and T2 (PedMidas median T0 = 30, T1 = 15, T2 = 7; p < 0,001, p < 0,001 respectively). Follow up data of a subgroup of patients 24 months after the treatment point to sustainable effects. CONCLUSIONS The interdisciplinary multimodal headache therapy program DreKiP reduces headache frequency and headache related disability significantly 6-12 months following its completion. TRIAL REGISTRATION DRKS00027523, retrospectively registered.
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Affiliation(s)
- Hanna Sobe
- Interdisciplinary Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany
| | - Matthias Richter
- Department of Pediatrics, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Reinhard Berner
- Department of Pediatrics, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Maja von der Hagen
- Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Antje Hähner
- Smell & Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - Ingo Röder
- NCT Partner Site Dresden, Institute for Medical Informatics and Biometrics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Thea Koch
- Department of Anesthesiology and Intensive Care, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Rainer Sabatowski
- Interdisciplinary Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.,Department of Anesthesiology and Intensive Care, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Anna Klimova
- NCT Partner Site Dresden, Institute for Medical Informatics and Biometrics, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Gudrun Gossrau
- Interdisciplinary Pain Center, University Hospital and Faculty of Medicine Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
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5
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Bonfert MV, Sollmann N, Renner T, Börner C, Urban G, Schandelmaier P, Hannibal I, Huß K, Parisi C, Gerstl L, Vill K, Blaschek A, Koenig H, Klose B, Heinen F, Landgraf MN, Albers L. Burden of disease and lifestyle habits in adolescents and young adults prone
to frequent episodic migraine: A secondary comparative analysis. J Child Health Care 2022; 26:215-227. [PMID: 33955272 PMCID: PMC9194962 DOI: 10.1177/13674935211008712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to assess the burden of disease and prevalence of lifestyle factors for adolescents and young adults with frequent episodic migraine. We conducted a secondary comparative analysis of data collected during two previous studies. Inclusion criteria for this analysis were age 15-35 years, 15 to 44 migraine episodes within 12 weeks, and completeness of Migraine Disability Assessment and lifestyle questionnaire data. Datasets of 37 adults (median age [interquartile range]: 25 [6]) and 27 adolescents (median age [interquartile range]: 15 [1]) were analyzed. 81% (n = 30) of adults reported severe disability (16% [n = 3] of adolescents; p < 0.001). Headache frequency (24 vs. 17 days; p = 0.005) and prevalence of regular analgesic use (60% [n = 22] vs. 18% [n = 5]; p = 0.002) were significantly higher in adults. In adults, sleep duration on weekdays was significantly lower (8.5 vs. 10 h; p < 0.001). Any consumption of caffeine tended to be higher in adolescents and alcohol consumption tended to be higher in adults (p > 0.05). This study underlines the importance of educating adolescents and young adults with migraine about lifestyle habits that are likely to interfere with the condition.
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Affiliation(s)
- Michaela V Bonfert
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany,Michaela V Bonfert, Department of Pediatric
Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity,
Dr von Hauner Children’s Hospital, LMU Hospital, Lindwurmstraße 4, Munich, Bavaria 80337,
Germany.
| | - Nico Sollmann
- Department of Diagnostic and Interventional
Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Germany,TUM-Neuroimaging Center, Klinikum Rechts
der Isar, Technical University of Munich, Germany,Department of Diagnostic and Interventional
Radiology, University Hospital Ulm, Germany
| | - Tabea Renner
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Corinna Börner
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Giada Urban
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Paul Schandelmaier
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Iris Hannibal
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Kristina Huß
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Carmen Parisi
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Lucia Gerstl
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Katharina Vill
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Astrid Blaschek
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Helene Koenig
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Birgit Klose
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Florian Heinen
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Mirjam N Landgraf
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Lucia Albers
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany,Department of Neurosurgery, Klinikum Rechts
der Isar, Technical University of Munich, Germany
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6
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Gazerani P. Migraine and Mood in Children. Behav Sci (Basel) 2021; 11:bs11040052. [PMID: 33919881 PMCID: PMC8070834 DOI: 10.3390/bs11040052] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/11/2021] [Accepted: 04/12/2021] [Indexed: 02/07/2023] Open
Abstract
Migraine is one of the most prevalent headache disorders in children and negatively influences their quality of life. Physical, social, and school functioning are negatively affected. Mood changes are common in migraineurs and may happen before, during, or after a migraine headache. Children with migraine are not exempt from mood swings. The majority of mood changes occur during the prodromal phase, manifesting as a psychobiological response, e.g., difficulty thinking, trouble concentrating, irritability, higher or lower energy, confusion, and depression. A bi-directional relationship between migraine and mood has been proposed, but mechanisms are not clear. Collectively, a maladaptive stress response has been suggested to explain the inability to balance homoeostatic changes when facing various stressors. Recognizing mood changes and monitoring mood patterns in children with migraine, for example, by various apps and so-called mood monitors, is valuable for better management. A multidisciplinary intervention has been recommended to reduce migraine disability, improve coping strategies, and reduce chronification risks in children with migraine. Pharmacological and non-pharmacological strategies are both available and effective. Biofeedback, relaxation, and cognitive-behavioral therapy yield positive outcomes in pediatric migraine. Developing healthy lifestyle habits (diet, exercise, sleep) also seems to improve migraine in this population.
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Affiliation(s)
- Parisa Gazerani
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway;
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9229 Aalborg E, Denmark;
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7
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Martí L, Castarlenas E, Solé E, de la Vega R, Miró J. Video-based Pain Education in Schools: A Study With Adolescents. Clin J Pain 2021; 37:199-205. [PMID: 33290347 DOI: 10.1097/ajp.0000000000000906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/11/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE School-based educational programs have shown positive changes in health-related behaviors among adolescents. The aim of this study was to analyze the changes in pain-related knowledge among adolescents and in the use of positive responses to their peers' pain behaviors after watching a brief educational video. METHODS One hundred and thirty-five adolescents (mean age=13.27; SD=1.17) participated and provided demographic and pain-related information. They also responded to a pain-related knowledge questionnaire before (T1), after (T2), and 1 month after (T3) watching a brief pain educational video, and to a modified version of the Inventory of Parent/Caregiver Responses to the Children's Pain Experience at T1 and at T3. RESULTS There was a significant increase in pain knowledge for all participants between T1 and T2 (η2p=0.73) and between T1 and T3 (η2p=0.62). An increase in responses considered to be positive to peers' pain behaviors (ie, the promotion of well-behaviors and coping responses) 1 month after watching the educational video was also found. Interestingly, these results were not associated with the chronic pain status of the participant. DISCUSSION The findings showed that a brief and inexpensive educational video-based intervention in schools helps to increase pain-related knowledge and change responses to students with chronic pain. This has the potential to prevent chronic pain and related disability among students, and decrease bullying-like behaviors toward students with chronic pain.
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Affiliation(s)
- Lorena Martí
- Unit for the Study and Treatment of Pain-ALGOS, Universitat Rovira i Virgili
- Department of Psychology, Research Center for Behavior Assessment (CRAMC)
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia
| | - Elena Castarlenas
- Unit for the Study and Treatment of Pain-ALGOS, Universitat Rovira i Virgili
- Department of Psychology, Research Center for Behavior Assessment (CRAMC)
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia
| | - Ester Solé
- Unit for the Study and Treatment of Pain-ALGOS, Universitat Rovira i Virgili
- Department of Psychology, Research Center for Behavior Assessment (CRAMC)
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia
| | | | - Jordi Miró
- Unit for the Study and Treatment of Pain-ALGOS, Universitat Rovira i Virgili
- Department of Psychology, Research Center for Behavior Assessment (CRAMC)
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia
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8
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Yamanaka G, Morichi S, Suzuki S, Go S, Takeshita M, Kanou K, Ishida Y, Oana S, Kawashima H. A Review on the Triggers of Pediatric Migraine with the Aim of Improving Headache Education. J Clin Med 2020; 9:jcm9113717. [PMID: 33228144 PMCID: PMC7699367 DOI: 10.3390/jcm9113717] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 12/18/2022] Open
Abstract
Although migraines are common in children and adolescents, they have a robustly negative impact on the quality of life of individuals and their families. The current treatment guidelines outline the behavioral and lifestyle interventions to correct common causative factors, such as negative emotional states, lack of exercise and sleep, and obesity; however, the evidence of their effectiveness is insufficient. To create a plan for disseminating optimal pediatric headache education, we reviewed the current evidence for factors correlated with migraine. We assessed three triggers or risk factors for migraines in children and adolescents: stress, sleep poverty, and alimentation (including diet and obesity). While there is a gradual uptick in research supporting the association between migraine, stress, and sleep, the evidence for diet-related migraines is very limited. Unless obvious dietary triggers are defined, clinicians should counsel patients to eat a balanced diet and avoid skipping meals rather than randomly limiting certain foods. We concluded that there is not enough evidence to establish a headache education plan regarding behavioral and lifestyle interventions. Clinicians should advise patients to avoid certain triggers, such as stress and sleep disorders, and make a few conservative dietary changes.
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9
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Wager J, Stahlschmidt L, Heuer F, Troche S, Zernikow B. The impact of a short educational movie on promoting chronic pain health literacy in school: A feasibility study. Eur J Pain 2018; 22:1142-1150. [DOI: 10.1002/ejp.1202] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 11/06/2022]
Affiliation(s)
- J. Wager
- German Paediatric Pain Centre; Children's and Adolescents’ Hospital Datteln; Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care; University of Witten/Herdecke; Faculty of Health, School of Medicine, Witten; Germany
| | - L. Stahlschmidt
- German Paediatric Pain Centre; Children's and Adolescents’ Hospital Datteln; Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care; University of Witten/Herdecke; Faculty of Health, School of Medicine, Witten; Germany
| | - F. Heuer
- German Paediatric Pain Centre; Children's and Adolescents’ Hospital Datteln; Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care; University of Witten/Herdecke; Faculty of Health, School of Medicine, Witten; Germany
| | - S. Troche
- Department of Psychology and Psychotherapy; University of Witten/Herdecke, Witten; Germany
| | - B. Zernikow
- German Paediatric Pain Centre; Children's and Adolescents’ Hospital Datteln; Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care; University of Witten/Herdecke; Faculty of Health, School of Medicine, Witten; Germany
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10
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Filippopulos FM, Albers L, Straube A, Gerstl L, Blum B, Langhagen T, Jahn K, Heinen F, von Kries R, Landgraf MN. Vertigo and dizziness in adolescents: Risk factors and their population attributable risk. PLoS One 2017; 12:e0187819. [PMID: 29131843 PMCID: PMC5683632 DOI: 10.1371/journal.pone.0187819] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/26/2017] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To assess potential risk factors for vertigo and dizziness in adolescents and to evaluate their variability by different vertigo types. The role of possible risk factors for vertigo and dizziness in adolescents and their population relevance needs to be addressed in order to design preventive strategies. STUDY DESIGN The study population consisted of 1482 school-children between the age of 12 and 19 years, who were instructed to fill out a questionnaire on different vertigo types and related potential risk factors. The questionnaire specifically asked for any vertigo, spinning vertigo, swaying vertigo, orthostatic dizziness, and unspecified dizziness. Further a wide range of potential risk factors were addressed including gender, stress, muscular pain in the neck and shoulder region, sleep duration, migraine, coffee and alcohol consumption, physical activity and smoking. RESULTS Gender, stress, muscular pain in the neck and shoulder region, sleep duration and migraine were identified as independent risk factors following mutual adjustment: The relative risk was 1.17 [1.10-1.25] for female sex, 1.07 [1.02-1.13] for stress, 1.24 [1.17-1.32] for muscular pain, and 1.09 [1.03-1.14] for migraine. The population attributable risk explained by these risk factors was 26%, with muscular pain, stress, and migraine accounting for 11%, 4%, and 3% respectively. CONCLUSION Several established risk factors in adults were also identified in adolescents. Risk factors amenable to prevention accounted for 17% of the total population risk. Therefore, interventions targeting these risk factors may be warranted.
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Affiliation(s)
- Filipp M. Filippopulos
- Department of Neurology, University Hospital, LMU, Munich, Germany
- German Center for Vertigo and Balance Disorders, LMU, Munich, Germany
| | - Lucia Albers
- Institute of Social Paediatrics and Adolescents Medicine, Division of Epidemiology, LMU, Munich, Germany
| | - Andreas Straube
- Department of Neurology, University Hospital, LMU, Munich, Germany
- German Center for Vertigo and Balance Disorders, LMU, Munich, Germany
| | - Lucia Gerstl
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, LMU, Munich, Germany
| | - Bernhard Blum
- Department of Neurology, University Hospital, LMU, Munich, Germany
| | - Thyra Langhagen
- German Center for Vertigo and Balance Disorders, LMU, Munich, Germany
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, LMU, Munich, Germany
| | - Klaus Jahn
- German Center for Vertigo and Balance Disorders, LMU, Munich, Germany
- Department of Neurology, Schön Klinik Bad Aibling, Bad Aibling, Germany
| | - Florian Heinen
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, LMU, Munich, Germany
| | - Rüdiger von Kries
- Institute of Social Paediatrics and Adolescents Medicine, Division of Epidemiology, LMU, Munich, Germany
| | - Mirjam N. Landgraf
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, LMU, Munich, Germany
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11
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Richter M, Gruhl E, Lautenschläger E, Müller T, Schumann F, Skiera D, Theisinger A, Zimmer U, Berner R, von der Hagen M, Sabatowski R, Hähner A, Gossrau G. [DreKiP - an outpatient treatment program for children and adolescents with headache]. Schmerz 2017; 32:17-29. [PMID: 28956173 DOI: 10.1007/s00482-017-0245-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Headaches are a frequent health problem among children and adolescents. The ocurrence of headaches and the resulting impairments in the quality of life and activities of daily living are modulated by biopsychosocial interactions, which necessitate a complex treatment program. The Dresden Childrens Headache Program (DreKiP) is a multidisciplinary therapy program consisting of eight modules for children and adolescents: education, stress relief, relaxation techniques, physical fitness, climbing therapy, art therapy and sensory training. In addition, there are six modules containing parallel workshops for parents. This outpatient program lasts 2-3 months and is performed parallel to the daily and school routine. Therapy groups consist of 6-8 patients in each age group. In total patients receive 15 h and the parents 7 h of therapy. Concomitant with the program, headache-associated data, such as headache frequency, medication use and school absence are documented. So far 32 children and adolescents in groups of 11, 14-15, 14-16, 17 and 17-18 years old completed the program. Of the 32 patients 19 presented with migraine and tension type headache, 6/32 with migraine and 7/32 with tension type headache only. The median number of headache days was 15 per month and 4 official school absence days per month. Preliminary results 6 months after the end of the therapy program showed reduced frequency of headaches in three quarters of our patients. The headache frequency was reduced from an initial median of 15 days per month to a median of 8 days per month after the program. The multidisciplinary program DreKiP improves the use of therapeutic means in children and adolescents with primary headaches. Children and adolescents with headache-related impairment in activities of daily life in school and leisure times constitute the target group of this therapy.
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Affiliation(s)
- M Richter
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Dresden, Dresden, Deutschland
| | - E Gruhl
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - E Lautenschläger
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - T Müller
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Dresden, Dresden, Deutschland
| | - F Schumann
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - D Skiera
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - A Theisinger
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - U Zimmer
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - R Berner
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Dresden, Dresden, Deutschland
| | - M von der Hagen
- Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - R Sabatowski
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Dresden, Dresden, Deutschland
| | - A Hähner
- Interdisziplinäres Zentrum für Riechen und Schmecken, Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Dresden, Dresden, Deutschland
| | - G Gossrau
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
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12
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Sunguya BF, Mlunde LB, Urassa DP, Poudel KC, Ubuguyu OS, Mkopi NP, Leyna GH, Kessy AT, Nanishi K, Shibanuma A, Yasuoka J, Jimba M. Improving feeding and growth of HIV-positive children through nutrition training of frontline health workers in Tanga, Tanzania. BMC Pediatr 2017; 17:94. [PMID: 28376725 PMCID: PMC5379502 DOI: 10.1186/s12887-017-0840-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 03/18/2017] [Indexed: 11/10/2022] Open
Abstract
Background Nutrition training can boost competence of health workers to improve children’s feeding practices. In this way, child undernutrition can be ameliorated in general populations. However, evidence is lacking on efficacy of such interventions among Human Immunodeficiency Virus (HIV)-positive children. We aimed to examine the efficacy of a nutrition training intervention to improve midlevel providers’ (MLPs) nutrition knowledge and feeding practices and the nutrition statuses of HIV-positive children in Tanga, Tanzania. Methods This cluster-randomized controlled trial was conducted in 16 out of 32 care and treatment centers (CTCs) in Tanga. Eight CTCs were assigned to the intervention arm and a total of 16 MLPs received nutrition training and provided nutrition counseling and care to caregivers of HIV-positive children. A total of 776 pairs of HIV-positive children and their caregivers were recruited, of whom 397 were in the intervention arm. Data were analyzed using instrumental variable random effects regression with panel data to examine the efficacy of the intervention on nutrition status through feeding practices. Results Mean nutrition knowledge scores were higher post-training compared to pre-training among MLPs (37.1 vs. 23.5, p < 0.001). A mean increment weight gain of 300 g was also observed at follow-up compared to baseline among children of the intervention arm. Feeding frequency and dietary diversity improved following the intervention and a 6 months follow-up (p < 0.001). An increase in each unit of feeding frequency and dietary diversity were associated with a 0.15-unit and a 0.16-unit respectively decrease in the child underweight (p < 0.001). Conclusions Nutrition training improved nutrition knowledge among MLPs caring for HIV-positive children attending CTCs in Tanga, Tanzania. Caregivers’ feeding practices also improved, which in turn led to a modest weight gain among HIV-positive children. To sustain weight gain, efforts should be made to also improve households’ food security and caregivers’ education in addition to inservice nutrition trainings. The protocol was registered on 15/02/2013, before the recruitment at ISRCTN trial registry with the trial registration number: ISRCTN65346364.
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Affiliation(s)
- Bruno F Sunguya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O Box 65489, Dar es Salaam, Tanzania.
| | - Linda B Mlunde
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - David P Urassa
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O Box 65489, Dar es Salaam, Tanzania
| | - Krishna C Poudel
- Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts Amherst, Arnold House, 715 North Pleasant St, Amherst, MA, 01003-9304, USA
| | - Omary S Ubuguyu
- Muhimbili National Hospital, P.O. Box 65000, Dar es Salaam, Tanzania
| | - Namala P Mkopi
- Muhimbili National Hospital, P.O. Box 65000, Dar es Salaam, Tanzania
| | - Germana H Leyna
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O Box 65489, Dar es Salaam, Tanzania
| | - Anna T Kessy
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O Box 65489, Dar es Salaam, Tanzania
| | - Keiko Nanishi
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Akira Shibanuma
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Junko Yasuoka
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
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13
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Affiliation(s)
- A H V Schapira
- Clinical Neurosciences, UCL Institute of Neurology, London, UK
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14
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Petersen I, Evans-Lacko S, Semrau M, Barry MM, Chisholm D, Gronholm P, Egbe CO, Thornicroft G. Promotion, prevention and protection: interventions at the population- and community-levels for mental, neurological and substance use disorders in low- and middle-income countries. Int J Ment Health Syst 2016; 10:30. [PMID: 27069506 PMCID: PMC4827227 DOI: 10.1186/s13033-016-0060-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 03/23/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In addition to services within the health system, interventions at the population and community levels are also important for the promotion of mental health, primary prevention of mental, neurological and substance use (MNS) disorders, identification and case detection of MNS disorders; and to a lesser degree treatment, care and rehabilitation. This study aims to identify "best practice" and "good practice" interventions that can feasibly be delivered at these population- and community-levels in low- and middle-income countries (LMICs), to aid the identification of resource efficiencies and allocation in LMICs. METHODS A narrative review was conducted given the wide range of relevant interventions. Expert consensus was used to identify "best practice" at the population-level on the basis of existing quasi-experimental natural experiments and cost effectiveness, with small scale emerging and promising evidence comprising "good practice". At the community-level, using expert consensus, the ACE (Assessing Cost-Effectiveness in Prevention Project) grading system was used to differentiate "best practice" interventions with sufficient evidence from "good practice" interventions with limited but promising evidence. RESULTS At the population-level, laws and regulations to control alcohol demand and restrict access to lethal means of suicide were considered "best practice". Child protection laws, improved control of neurocysticercosis and mass awareness campaigns were identified as "good practice". At the community level, socio-emotional learning programmes in schools and parenting programmes during infancy were identified as "best practice". The following were all identified as "good practice": Integrating mental health promotion strategies into workplace occupational health and safety policies; mental health information and awareness programmes as well as detection of MNS disorders in schools; early child enrichment/preschool educational programs and parenting programs for children aged 2-14 years; gender equity and/or economic empowerment programs for vulnerable groups; training of gatekeepers to identify people with MNS disorders in the community; and training non-specialist community members at a neighbourhood level to assist with community-based support and rehabilitation of people with mental disorders. CONCLUSION Interventions provided at the population- and community-levels have an important role to play in promoting mental health, preventing the onset, and protecting those with MNS disorders. The importance of inter-sectoral engagement and the need for further research on interventions at these levels in LMICs is highlighted.
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Affiliation(s)
- Inge Petersen
- Centre for Rural Health, School of Nursing and Public Health and School of Applied Human Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Sara Evans-Lacko
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Maya Semrau
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Margaret M Barry
- World Health Organization Collaborating Centre for Health Promotion Research, National University of Ireland Galway, Galway, Ireland
| | - Dan Chisholm
- Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
| | - Petra Gronholm
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Catherine O Egbe
- School of Applied Human Sciences, University of KwaZulu Natal, Durban, South Africa ; Center for Tobacco Control Research and Education, University of California, San Francisco, USA
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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15
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Langhagen T, Albers L, Heinen F, Straube A, Filippopulos F, Landgraf MN, Gerstl L, Jahn K, von Kries R. Period Prevalence of Dizziness and Vertigo in Adolescents. PLoS One 2015; 10:e0136512. [PMID: 26361225 PMCID: PMC4567278 DOI: 10.1371/journal.pone.0136512] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 08/04/2015] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To assess the period prevalence and severity of dizziness and vertigo in adolescents. METHODS In 1661 students in 8th-10th grade in twelve grammar schools in Munich, Germany information on vertigo/dizziness was assessed by a questionnaire in the class room setting. Three month prevalence of dizziness/vertigo was estimated; symptoms were categorized as orthostatic dizziness, spinning vertigo, swaying vertigo or unspecified dizziness. Duration of symptoms and impact on daily life activities were assessed. RESULTS 72.0% (95%-CI = [69.8-74.2]; N = 1196) of the students (mean age 14.5±1.1) reported to suffer from at least one episode of dizziness or vertigo in the last three months. Most adolescents ticked to have symptoms of orthostatic dizziness (52.0%, 95%-CI = [49.5-54.4], N = 863). The period prevalence for the other types of vertigo were spinning vertigo: 11.6%, 95%-CI = [10.1-13.3], N = 193; swaying vertigo: 12.2%, 95%-CI = [10.6-13.8], N = 202; and unspecified dizziness: 15.2%, 95%-CI = [13.5-17.1], N = 253. About 50% of students with spinning vertigo and swaying vertigo also report to have orthostatic dizziness. Most vertigo/dizziness types were confined to less than one minute on average. The proportion of students with any dizziness/vertigo accounting for failure attending school, leisure activities or obliging them to stay in bed were more pronounced for spinning or swaying vertigo. CONCLUSION Dizziness and vertigo in grammar school students appear to be as common as in adults. In face of the high period prevalence and clinical relevance of dizziness/vertigo in adolescents there is a need for prevention strategies. Risk factors for dizziness/vertigo need to be assessed to allow for conception of an intervention programme.
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Affiliation(s)
- Thyra Langhagen
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
| | - Lucia Albers
- Institut of Social Paediatrics and Adolescents Medicine, Division of Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - Florian Heinen
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
| | - Andreas Straube
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Filipp Filippopulos
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Mirjam N. Landgraf
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
| | - Lucia Gerstl
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, Ludwig-Maximilians-University, Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
| | - Klaus Jahn
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-University, Munich, Germany
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
- Schön Klinik Bad Aibling, Bad Aibling, Germany
| | - Rüdiger von Kries
- Institut of Social Paediatrics and Adolescents Medicine, Division of Epidemiology, Ludwig-Maximilians-University, Munich, Germany
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17
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Albers L, Straube A, Landgraf MN, Filippopulos F, Heinen F, von Kries R. Migraine and tension type headache in adolescents at grammar school in Germany - burden of disease and health care utilization. J Headache Pain 2015; 16:534. [PMID: 26055241 PMCID: PMC4467810 DOI: 10.1186/s10194-015-0534-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 05/25/2015] [Indexed: 01/03/2023] Open
Abstract
Background Tension-type headache and migraine are among the most prevalent chronic disorders in children/adolescents. Data on health care utilization for headache in this age group, however, are sparse. Methods In 1399 grammar school students (aged 12–19 years) with headache in the last six months in Germany a) the burden of disease for headache (mean intensity, mean frequency in the last three months and PedMIDAS means), b) medical care utilization defined by proportion of students consulting a physician in the last 12 months and/or taking analgetic drugs in the last three months by headache types (migraine and tension-type headache) and by burden of disease were assessed. Results Primary headache substantially impaired daily living activities in adolescents which was mainly related to migraine. Medical care utilization and drug use, however, was low (consulting a physician: 12.0 %, 95 %-CI = [10.3-13.8]; taking analgetic drugs: 29.9 %, 95 %-CI = [27.5-32.4]) - even among students with severe headache (physician consultation: <35 %; taking analgetic drugs: <63 %). Two thirds of students with any headache and 40 % of those with migraine had neither seen a physician nor used analgetic drugs because of their headache in the preceding 12 months. Conclusions Adolescents with headache might too rarely seek professional help for treatment of headache. Health promotion in adolescents should increase awareness for evidence-based treatment options for headache. Electronic supplementary material The online version of this article (doi:10.1186/s10194-015-0534-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lucia Albers
- Institute of Social Paediatrics and Adolescents Medicine, Division of Epidemiology, Ludwig-Maximilians-University Munich, 80337, Munich, Germany,
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