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Genc D, Vaičienė-Magistris N, Zaborskis A, Şaşmaz T, Tunç AY, Uluduz D, Wöber C, Wöber-Bingöl Ç, Steiner TJ. The burden attributable to headache disorders in children and adolescents in Lithuania: estimates from a national schools-based study. J Headache Pain 2021; 22:24. [PMID: 33849431 PMCID: PMC8045274 DOI: 10.1186/s10194-021-01237-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/01/2021] [Indexed: 01/03/2023] Open
Abstract
Background We recently showed headache to be common in children (aged 7–11 years) and adolescents (aged 12–17) in Lithuania. Here we provide evidence from the same study of the headache-attributable burden. Methods Following the generic protocol for Lifting The Burden’s global schools-based study, this cross-sectional survey administered self-completed structured questionnaires to pupils within classes in 24 nationally representative schools selected from seven regions of the country. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH; defined as mild headache with usual duration < 1 h). Burden enquiry was conducted in multiple domains. Results Questionnaires were completed by 2505 pupils (1382 children, 1123 adolescents; participating proportion 67.4%), of whom 1858 reported headache in the preceding year, with mean frequency (±SD) of 3.7 ± 4.5 days/4 weeks and mean duration of 1.6 ± 1.9 h. Mean proportion of time in ictal state, estimated from these, was 0.9% (migraine 1.5%, probable medication-overuse headache [pMOH] 10.9%). Mean intensity on a scale of 1–3 was 1.6 ± 0.6 (mild-to-moderate). Symptomatic medication was consumed on 1.5 ± 2.8 days/4 weeks. Lost school time was 0.5 ± 1.5 days/4 weeks (migraine 0.7 ± 1.5, pMOH 5.0 ± 7.8) based on recall, but about 50% higher for migraine according to actual absences recorded in association with reported headache on the preceding day. More days were reported with limited activity (overall 1.2 ± 2.4, migraine 1.5 ± 2.2, pMOH 8.4 ± 8.5) than lost from school. One in 30 parents (3.3%) missed work at least once in 4 weeks because of their son’s or daughter’s headache. Emotional impact and quality-of-life scores generally reflected other measures of burden, with pMOH causing greatest detriments, followed by migraine and tension-type headache, and UdH least. Burdens were greater in adolescents than children as UdH differentiated into adult headache types. Conclusions Headache in children and adolescents in Lithuania is mostly associated with modest symptom burden. However, the consequential burdens, in particular lost school days, are far from negligible for migraine (which is prevalent) and very heavy for pMOH (which, while uncommon in children, becomes four-fold more prevalent in adolescents). These findings are of importance to both health and educational policies in Lithuania.
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Affiliation(s)
- Diana Genc
- Department of Neurology, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nerija Vaičienė-Magistris
- Department of Neurology, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Apolinaras Zaborskis
- Department of Preventive Medicine and Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Tayyar Şaşmaz
- Department of Public Health, Mersin University School of Medicine, Mersin, Turkey
| | - Aylin Yeniocak Tunç
- Department of Public Health, Mersin University School of Medicine, Mersin, Turkey
| | - Derya Uluduz
- Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Christian Wöber
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Çiçek Wöber-Bingöl
- Dr Gönül Bingöl-Dr Muammer Bingöl Çocuk ve Ergen Başağrısı Derneği - Society for Headache in Children and Adolescents, Suadiye, Istanbul, Turkey
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway. .,Division of Brain Sciences, Imperial College London, London, UK.
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Wöber C, Wöber-Bingöl Ç, Uluduz D, Aslan TS, Uygunoglu U, Tüfekçi A, Alp SI, Duman T, Sürgün F, Emir GK, Demir CF, Balgetir F, Özdemir YB, Auer T, Siva A, Steiner TJ. Undifferentiated headache: broadening the approach to headache in children and adolescents, with supporting evidence from a nationwide school-based cross-sectional survey in Turkey. J Headache Pain 2018; 19:18. [PMID: 29484508 PMCID: PMC5826911 DOI: 10.1186/s10194-018-0847-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/21/2018] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Headache is a leading disabler in adults worldwide. In children and adolescents, the same may be true but the evidence is much poorer. It is notable that published epidemiological studies of these age groups have largely ignored headaches not fulfilling any specific set of ICHD criteria, although such headaches appear to be common. A new approach to these is needed: here we introduce, and investigate, a diagnostic category termed "undifferentiated headache" (UdH), defined in young people as recurrent mild-intensity headache of < 1 h's duration. METHODS We conducted a nationwide cross-sectional survey in 31 schools in six regions of Turkey selected by mixed convenience-based and purposive modified cluster-sampling. A validated, standardised self-completed structured questionnaire was administered by a physician-investigator to entire classes of pupils aged 6-17 years. RESULTS Of the identified sample of 7889 pupils, 7088 (89.8%) participated. The 1-year prevalence of UdH was 29.2%, of migraine (definite and probable) 26.7%, and of tension-type headache (TTH) (definite and probable) 12.9%. UdH differed with respect to almost all headache features and associated symptoms from both migraine and TTH. Burden of headache and use of acute medication were lower in UdH than in migraine and TTH. Headache yesterday was less common in UdH than migraine (OR 0.32; 95% CI 0.28-0.37) and TTH (OR 0.64; 95% CI 0.56-0.77). Quality of life (QoL) was better in UdH (33.6 ± 5.2) than in migraine (30.3 ± 5.6; p < 0.001) and TTH (32.4 ± 5.3; p < 0.001), but worse than in pupils without headache (35.7 ± 4.7; p < 0.001). CONCLUSIONS This large nationwide study in Turkey of pupils aged 6-17 years has shown that many children and adolescents have a headache type that does not conform to existing accepted diagnostic criteria. This new diagnostic category of presumably still-evolving headache (undifferentiated headache) is common. UdH differs in almost all measurable respects from both migraine and TTH. Although characterised by mild headaches lasting < 1 h, UdH is associated with significant adverse impact on QoL. Longitudinal cohort studies are needed to evaluate the prognosis of UdH but, meanwhile, recognition of UdH and its distinction from migraine and TTH has implications for epidemiological studies, public-health policy and routine clinical practice.
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Affiliation(s)
- Christian Wöber
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Çiçek Wöber-Bingöl
- Dr Gönül Bingöl-Dr Muammer Bingöl Çocuk ve Ergen Başağrısı Derneği, Istanbul, Turkey
| | - Derya Uluduz
- Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Tuna Stefan Aslan
- Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Uğur Uygunoglu
- Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Tüfekçi
- Neurology Department, Recep Tayyip Erdoğan University School of Medicine, Rize, Turkey
| | - Selen Ilhan Alp
- Neurology Department, Namık Kemal University School of Medicine, Tekirdağ, Turkey
| | - Taşkın Duman
- Neurology Department, Mustafa Kemal University School of Medicine, Hatay, Turkey
| | - Fidan Sürgün
- Neurology Department, Mustafa Kemal University School of Medicine, Hatay, Turkey
| | | | - Caner Feyzi Demir
- Neurology Department, Fırat University School of Medicine, Elazığ, Turkey
| | - Ferhat Balgetir
- Neurology Department, Fırat University School of Medicine, Elazığ, Turkey
| | - Yeliz Bahar Özdemir
- Department of Physical Medicine and Rehabilitation, Marmara University Medical School, Istanbuk, Turkey
| | - Tanja Auer
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Aksel Siva
- Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway.
- Division of Brain Sciences, Imperial College London, London, UK.
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Zebenholzer K, Frantal S, Pablik E, Lieba-Samal D, Salhofer-Polanyi S, Wöber-Bingöl Ç, Wöber C. Reliability of assessing lifestyle and trigger factors in patients with migraine - findings from the PAMINA study. Eur J Neurol 2015; 23:120-6. [DOI: 10.1111/ene.12817] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 06/23/2015] [Indexed: 01/11/2023]
Affiliation(s)
- K. Zebenholzer
- Department of Neurology; Medical University of Vienna; Vienna Austria
| | - S. Frantal
- CeMSIIS Section for Medical Statistics; Medical University of Vienna; Vienna Austria
| | - E. Pablik
- CeMSIIS Section for Medical Statistics; Medical University of Vienna; Vienna Austria
| | - D. Lieba-Samal
- Department of Neurology; Medical University of Vienna; Vienna Austria
| | | | - Ç. Wöber-Bingöl
- Department of Child and Adolescent Psychiatry; Medical University of Vienna; Vienna Austria
| | - C. Wöber
- Department of Neurology; Medical University of Vienna; Vienna Austria
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Wöber-Bingöl Ç, Wöber C, Uluduz D, Uygunoğlu U, Aslan TS, Kernmayer M, Zesch HE, Gerges NTA, Wagner G, Siva A, Steiner TJ. The global burden of headache in children and adolescents - developing a questionnaire and methodology for a global study. J Headache Pain 2014; 15:86. [PMID: 25496532 PMCID: PMC4273720 DOI: 10.1186/1129-2377-15-86] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 11/13/2014] [Indexed: 12/18/2022] Open
Abstract
Background Burden of headache has been assessed in adults in countries worldwide, and is high, but data for children and adolescents are sparse. The objectives of this study were o develop a questionnaire and methodology for the global estimation of burden of headache in children and adolescents, to test these in use and to present preliminary data. Methods We designed structured questionnaires for mediated-group self-administration in schools by children aged 6-11 years and adolescents aged 12-17 years. In two pilot studies, we offered the questionnaires to pupils in Vienna and Istanbul. We performed face-to-face interviews in a randomly selected subsample of 199 pupils to validate the headache diagnostic questions. Results Data were collected from 1,202 pupils (mean 13.9 ± 2.4 years; 621 female, 581 male). The participation rate was 81.1% in Istanbul, 67.2% in Vienna. The questionnaire proved acceptable: ≤5% of participants disagreed partially or totally with its length, comprehensibility or simplicity. The sensitivity, specificity, positive and negative predictive values ranged between 0.71 and 0.76 for migraine and between 0.61 and 0.85 for tension-type headache (TTH). Cronbach’s alpha was 0.83. The 1-year prevalence of headache was 89.3%, of migraine 39.3% and of TTH 37.9%. The prevalence of headache on ≥15 days/month was 4.5%. One fifth (20.7%) of pupils with headache lost ≥1 day of school during the preceding 4 weeks and nearly half (48.8%) reported ≥1 day when they could not do activities they had wanted to. The vast majority of pupils with headache experienced difficulties in coping with headache and in concentrating during headache. Quality of life was poorer in pupils with headache than in those without. Conclusion These pilot studies demonstrate the usefulness of the questionnaires and feasibility of the methodology for assessing the global burden of headache in children and adolescents, and predict substantial impact of headache in these age groups.
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Affiliation(s)
- Çiçek Wöber-Bingöl
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
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Wöber-Bingöl Ç. Comorbidity of headache in children and adolescence. J Headache Pain 2013. [PMCID: PMC3620070 DOI: 10.1186/1129-2377-14-s1-o8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Wöber-Bingöl Ç. Comorbidity of headache in children and adolescence. J Headache Pain 2013. [DOI: 10.1186/1129-2377-1-s1-o8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Salhofer-Polanyi S, Frantal S, Brannath W, Seidel S, Wöber-Bingöl Ç, Wöber C. Prospective Analysis of Factors Related to Migraine Aura - The PAMINA Study. Headache 2012; 52:1236-45. [DOI: 10.1111/j.1526-4610.2012.02166.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Karwautz A, Völkl-Kernstock S, Nobis G, Kalchmayr G, Hafferl-Gattermayer A, Wöber-Bingöl Ç, Friedrich MH. Characteristics of self-regulation in adolescent patients with anorexia nervosa. ACTA ACUST UNITED AC 2011. [DOI: 10.1348/000711201160830] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Seidel S, Karwautz A, Wagner G, Zormann A, Eder H, Huemer J, Nattiashvili S, Wöber C, Wöber-Bingöl Ç. Migraine in Patients With Eating Disorders: A Study Using a Sister-Pair Comparison Design. Headache 2011; 51:220-5. [DOI: 10.1111/j.1526-4610.2010.01822.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Özge A, Termine C, Antonaci F, Natriashvili S, Guidetti V, Wöber-Bingöl Ç. Overview of diagnosis and management of paediatric headache. Part I: diagnosis. J Headache Pain 2011; 12:13-23. [PMID: 21359874 PMCID: PMC3056001 DOI: 10.1007/s10194-011-0297-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 11/25/2010] [Indexed: 11/05/2022] Open
Abstract
Headache is the most common somatic complaint in children and adolescents. The evaluation should include detailed history of children and adolescents completed by detailed general and neurological examinations. Moreover, the possible role of psychological factors, life events and excessively stressful lifestyle in influencing recurrent headache need to be checked. The choice of laboratory tests rests on the differential diagnosis suggested by the history, the character and temporal pattern of the headache, and the physical and neurological examinations. Subjects who have any signs or symptoms of focal/progressive neurological disturbances should be investigated by neuroimaging techniques. The electroencephalogram and other neurophysiological examinations are of limited value in the routine evaluation of headaches. In a primary headache disorder, headache itself is the illness and headache is not attributed to any other disorder (e.g. migraine, tension-type headache, cluster headache and other trigeminal autonomic cephalgias). In secondary headache disorders, headache is the symptom of identifiable structural, metabolic or other abnormality. Red flags include the first or worst headache ever in the life, recent headache onset, increasing severity or frequency, occipital location, awakening from sleep because of headache, headache occurring exclusively in the morning associated with severe vomiting and headache associated with straining. Thus, the differential diagnosis between primary and secondary headaches rests mainly on clinical criteria. A thorough evaluation of headache in children and adolescents is necessary to make the correct diagnosis and initiate treatment, bearing in mind that children with headache are more likely to experience psychosocial adversity and to grow up with an excess of both headache and other physical and psychiatric symptoms and this creates an important healthcare problem for their future life.
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Affiliation(s)
- Aynur Özge
- Department of Neurology, Mersin University School of Medicine, Mersin, Turkey
| | - Cristiano Termine
- Child Neuropsychiatry Unit, Department of Experimental Medicine, University of Insubria, Varese, Italy
| | - Fabio Antonaci
- University Center for Adaptive Disorders and Headache (UCADH), Unit of Pavia, Pavia, Italy
| | - Sophia Natriashvili
- Department of Psychiatry of Childhood and Adolescence, Medical University of Vienna, Vienna, Austria
| | - Vincenzo Guidetti
- Department of Child and Adolescent Neuropsychiatry, University La Sapienza, Rome, Italy
| | - Çiçek Wöber-Bingöl
- Department of Psychiatry of Childhood and Adolescence, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
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Termine C, Özge A, Antonaci F, Natriashvili S, Guidetti V, Wöber-Bingöl Ç. Overview of diagnosis and management of paediatric headache. Part II: therapeutic management. J Headache Pain 2011; 12:25-34. [PMID: 21170567 PMCID: PMC3072476 DOI: 10.1007/s10194-010-0256-6] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Accepted: 09/07/2010] [Indexed: 12/12/2022] Open
Abstract
A thorough evaluation of headache in children and adolescents is necessary to make the correct diagnosis and initiate treatment. In part 1 of this article (Özge et al. in J Headache Pain, 2010), we reviewed the diagnosis of headache in children and adolescents. In the present part, we will discuss therapeutic management of primary headaches. An appropriate management requires an individually tailored strategy giving due consideration to both non-pharmacological and pharmacological measures. Non-pharmacological treatments include relaxation training, biofeedback training, cognitive-behavioural therapy, different psychotherapeutic approaches or combinations of these treatments. The data supporting the effectiveness of these therapies are less clear-cut in children than in adults, but that is also true for the data supporting medical treatment. Management of migraine and TTH should include strategies relating to daily living activities, family relationships, school, friends and leisure time activities. In the pharmacological treatment age and gender of children, headache diagnosis, comorbidities and side effects of medication must be considered. The goal of symptomatic treatment should be a quick response with return to normal activity and without relapse. The drug should be taken as early as possible and in the appropriate dosage. Supplementary measures such as rest in a quiet, darkened room is recommended. Pharmaco-prophylaxis is only indicated if lifestyle modification and non-pharmacological prophylaxis alone are not effective. Although many prophylactic medications have been tried in paediatric migraine, there are only a few medications that have been studied in controlled trials. Multidisciplinary treatment is an effective strategy for children and adolescents with improvement of multiple outcome variants including frequency and severity of headache and school days missed because of headache. As a growing problem both children and families should be informed about medication overuse and the children's drug-taking should be checked.
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Affiliation(s)
- Cristiano Termine
- Child Neuropsychiatry Unit, Department of Experimental Medicine, University of Insubria, Como, Italy
| | - Aynur Özge
- Department of Neurology, Mersin University School of Medicine, Mersin, Turkey
| | - Fabio Antonaci
- Unit of Pavia, University Center for Adaptive Disorders and Headache (UCADH), Pavia, Italy
| | - Sophia Natriashvili
- Department of Psychiatry of Childhood and Adolescence, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
| | - Vincenzo Guidetti
- Department of Child and Adolescent Neuropsychiatry, University La Sapienza, Rome, Italy
| | - Çiçek Wöber-Bingöl
- Department of Psychiatry of Childhood and Adolescence, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria
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12
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Lieba-Samal D, Bartl S, Salhofer S, Prajsnar A, Massl R, Freydl E, Fathinia P, Wöber-Bingöl Ç, Wöber C. The Course of Migraine—A Diary Study in Unselected Patients. Cephalalgia 2009; 29:1049-58. [DOI: 10.1111/j.1468-2982.2008.01838.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The course of disease and the predictive value of depression and anxiety in patients with migraine were prospectively examined. We recruited 393 migraineurs through articles in newspapers and performed a follow-up examination 30 months later. At baseline and follow-up, patients underwent a semi-structured interview, filled out the Headache Impact Test (HIT-6), Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS) and they kept a headache diary for 30 days. One hundred and fifty-one patients (38.6%) were seen at follow-up. The baseline data of patients with and without follow-up were comparable. At follow-up the number of headache days per month had decreased from 9.6 ± 5.8 to 8.1 ± 6.3 ( P < 0.001) and the proportion of patients with chronic headache (15.4%) and medication overuse (13%) had remained stable. SDS and SAS scores were associated with a high migraine frequency and high initial SDS scores predicted high migraine frequency at follow-up. This longitudinal study in unselected patients with migraine not excluding subjects with chronic headache, medication overuse, depression or anxiety does not point towards migraine as a progressive disease in the vast majority of patients and confirms the importance of psychiatric comorbidity.
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Affiliation(s)
- D Lieba-Samal
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - S Bartl
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - S Salhofer
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - A Prajsnar
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - R Massl
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - E Freydl
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - P Fathinia
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Ç Wöber-Bingöl
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - C Wöber
- Department of Neurology, Medical University of Vienna, Vienna, Austria
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Seidel S, Hartl T, Weber M, Matterey S, Paul A, Riederer F, Gharabaghi M, Wöber-Bingöl Ç, Wöber C. Quality of Sleep, Fatigue and Daytime Sleepiness in Migraine—A Controlled Study. Cephalalgia 2009; 29:662-9. [DOI: 10.1111/j.1468-2982.2008.01784.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The objective of this study was to evaluate whether the quality of sleep and the degree of fatigue and daytime sleepiness are related to migraine. We investigated 489 subjects comprising 97 patients with eight or more, 77 patients with five to seven and 196 patients with one to four migraine days per month, and 119 migraine-free controls with fewer than six headache days per year. The patients were recruited via articles in newspapers not stressing the subject of the study. All participants underwent a semistructured interview and completed the Pittsburgh Sleep Quality Index (PSQI), the Fatigue Severity Scale (FSS), the Epworth Sleepiness Scale (ESS) and the Self-rating Depression Scale and the Self-rating Anxiety Scale. For statistical analysis we used two way MANOVAs, post hoc univariate two-way ANOVAs and Hochberg's GT2 tests as well as three-way mixed design ANOVAs. The PSQI total score was highest in patients with frequent migraine (5.9 ± 4.3) and lowest in controls (4.3 ± 2.5, P = 0.04). Four subscores of the PSQI showed similar statistically significant differences. The FSS and ESS scores did not differ in the four study groups. Analysing depression and anxiety revealed a significant impact on PSQI, FSS and ESS, but did not demonstrate interactions with migraine, thus suggesting that the impact of migraine is similar in patients without and with psychiatric comorbidity. In conclusion, the quality of sleep is decreased in patients with migraine, whereas fatigue and daytime sleepiness do not differ from healthy controls. The decreased quality of sleep in migraineurs is also a consequence of migraine itself and cannot be explained exclusively by comorbidity with depression or anxiety.
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Affiliation(s)
- S Seidel
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - T Hartl
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - M Weber
- Department of Radiology, Medical University of Vienna, Vienna, Austria
| | - S Matterey
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - A Paul
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - F Riederer
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - M Gharabaghi
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Ç Wöber-Bingöl
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - C Wöber
- Department of Neurology, Medical University of Vienna, Vienna, Austria
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14
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Zebenholzer K, Wöber C, Vigl M, Wessely P, Wöber-Bingöl Ç. Accurate Diagnosis of Facial Pain: Reply from the Authors. Cephalalgia 2006. [DOI: 10.1111/j.1468-2982.2006.01116_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Karin Zebenholzer
- Department of Neurology, Vienna Medical University, Währinger Güntel 18–20, A-1090 Vienna, Austria
| | - Christian Wöber
- Department of Neurology, Vienna Medical University, Währinger Güntel 18–20, A-1090 Vienna, Austria
| | - Marion Vigl
- Department of Neurology, Vienna Medical University, Währinger Güntel 18–20, A-1090 Vienna, Austria
| | - Peter Wessely
- Department of Neurology, Vienna Medical University, Währinger Güntel 18–20, A-1090 Vienna, Austria
| | - Çiçek Wöber-Bingöl
- Department of Neurology, Vienna Medical University, Währinger Güntel 18–20, A-1090 Vienna, Austria
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Wöber-Bingöl Ç, Wöber C, Karwautz A, Schnider P, Vesely C, Wagner-Ennsgraber C, Zebenholzer K, Wessely P. Tension-type headache in different age groups at two headache centers. Pain 1996; 67:53-58. [PMID: 8895231 DOI: 10.1016/0304-3959(96)03117-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
At two headache centers, one for children and adolescents and the other for adults, we investigated patients aged 5-80 years with episodic or chronic tension-type headache to evaluate the relation between age and headache characteristics as well as analgesics intake. We found an increasing headache frequency and duration, an increasing variability of the headache location, and an increasing frequency of nausea with increasing age. All other headache features did not depend on age. Additionally, our study revealed a marked increase of analgesics use in adults compared to children and adolescents. In conclusion, children, adolescents, and adults referred for tension-type headache show minor differences in some headache features, but a marked change of analgesics intake. The different headache symptoms may be causally related to age, but an influence of medication or other factors must also be considered.
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Affiliation(s)
- Çiçek Wöber-Bingöl
- Department of Neuropsychiatry of Childhood and Adolescence, University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria Department of Neurology, University of Vienna, Währinger Gürtel 18-20,A-1090 Vienna, Austria
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Wöher C, Oder W, Kollegger H, Prayer L, Baumgartner C, Wöber-Bingöl Ç, Wimherger D, Binder H, Deecke L. Posturographic Measurement of Body Sway in Survivors of Severe Closed Head Injury. Arch Phys Med Rehabil 1993. [DOI: 10.1016/s0003-9993(23)00005-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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