TY - JOUR
T1 - Biopsychosocial treatment response among youth with continuous headache
T2 - A retrospective, clinic-based study
AU - Reidy, Brooke L.
AU - Riddle, Emily J.
AU - Powers, Scott W.
AU - Slater, Shalonda K.
AU - Kacperski, Joanne
AU - Kabbouche, Marielle
AU - Peugh, James L.
AU - Hershey, Andrew D.
N1 - Publisher Copyright:
© 2023 American Headache Society.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Background: Youth with continuous (always present) headache are vastly understudied; much remains to be understood regarding treatment response in this population. Objective: To describe and explore biopsychosocial factors related to initial clinical outcomes among treatment-seeking youth with continuous headache. Methods: This retrospective cohort study extracted data of 782 pediatric patients (i.e., aged <18 years) with continuous headache from a large clinical repository. Youth in this study had experienced continuous headache for ≥1 month before presenting to a multidisciplinary headache specialty clinic appointment. Extracted data from this appointment included patients’ headache history, clinical diagnoses, and headache-related disability, as well as information about biopsychosocial factors implicated in headache management and/or maintenance (e.g., healthy lifestyle habits, history of feeling anxious or depressed). Additional data regarding patient headache characteristics, disability, and lifestyle habits were extracted from a subset of 529 youth who returned to clinic 4–16 weeks after their initial follow-up visit. After characterizing initial treatment response, exploratory analyses compared youth with the best and worst treatment outcomes on several potentially influential factors. Results: Approximately half of youth (280/526; 53.2%) continued to have continuous headache at follow-up, ~20% of youth (51/526) reported a significant (≥50%) reduction in headache frequency. Improvements in average headache severity (e.g., percentage with severe headaches at initial visit: 45.3% [354/771]; percentage with severe headaches at follow-up visit: 29.8% [156/524]) and headache-related disability were also observed (e.g., percentage severe disability at initial visit: 62.9% [490/779]; percentage severe disability at initial follow-up visit: 34.2% [181/529]). Individuals with the worst headache frequency and disability had a longer history of continuous headache (mean difference estimate = 5.76, p = 0.013) and worse initial disability than the best responders (χ2[3, 264] = 23.49, p < 0.001). They were also more likely to have new daily persistent headache (χ2[2, 264] = 12.61, p = 0.002), and were more likely to endorse feeling depressed (χ2[1, 260] = 11.46, p < 0.001). Conclusion: A notable percentage of youth with continuous headache show initial improvements in headache status. Prospective, longitudinal research is needed to rigorously examine factors associated with continuous headache treatment response.
AB - Background: Youth with continuous (always present) headache are vastly understudied; much remains to be understood regarding treatment response in this population. Objective: To describe and explore biopsychosocial factors related to initial clinical outcomes among treatment-seeking youth with continuous headache. Methods: This retrospective cohort study extracted data of 782 pediatric patients (i.e., aged <18 years) with continuous headache from a large clinical repository. Youth in this study had experienced continuous headache for ≥1 month before presenting to a multidisciplinary headache specialty clinic appointment. Extracted data from this appointment included patients’ headache history, clinical diagnoses, and headache-related disability, as well as information about biopsychosocial factors implicated in headache management and/or maintenance (e.g., healthy lifestyle habits, history of feeling anxious or depressed). Additional data regarding patient headache characteristics, disability, and lifestyle habits were extracted from a subset of 529 youth who returned to clinic 4–16 weeks after their initial follow-up visit. After characterizing initial treatment response, exploratory analyses compared youth with the best and worst treatment outcomes on several potentially influential factors. Results: Approximately half of youth (280/526; 53.2%) continued to have continuous headache at follow-up, ~20% of youth (51/526) reported a significant (≥50%) reduction in headache frequency. Improvements in average headache severity (e.g., percentage with severe headaches at initial visit: 45.3% [354/771]; percentage with severe headaches at follow-up visit: 29.8% [156/524]) and headache-related disability were also observed (e.g., percentage severe disability at initial visit: 62.9% [490/779]; percentage severe disability at initial follow-up visit: 34.2% [181/529]). Individuals with the worst headache frequency and disability had a longer history of continuous headache (mean difference estimate = 5.76, p = 0.013) and worse initial disability than the best responders (χ2[3, 264] = 23.49, p < 0.001). They were also more likely to have new daily persistent headache (χ2[2, 264] = 12.61, p = 0.002), and were more likely to endorse feeling depressed (χ2[1, 260] = 11.46, p < 0.001). Conclusion: A notable percentage of youth with continuous headache show initial improvements in headache status. Prospective, longitudinal research is needed to rigorously examine factors associated with continuous headache treatment response.
KW - adolescent
KW - child
KW - constant headache
KW - migraine
KW - new daily persistent headache
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U2 - 10.1111/head.14525
DO - 10.1111/head.14525
M3 - Article
C2 - 37313573
AN - SCOPUS:85163060981
SN - 0017-8748
VL - 63
SP - 942
EP - 952
JO - Headache
JF - Headache
IS - 7
ER -