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The Psychiatric Comorbidities of Migraine in Children and Adolescents

  • Psychological and Behavioral Aspects of Headache and Pain (D Buse, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Understanding comorbidities in migraine is important because it can help us understand disease pathophysiology while also aiding the development of more effective treatment strategies. Additionally, it can provide greater awareness about appropriate diagnosis, the need for additional disease screening, and the natural history of migraine. Psychiatric comorbidities have been independently studied in both adults and children with migraine because their presentations can be distinct, and the physiology in these two groups can be different.

Recent Findings

While symptoms of anxiety and depression seem to be comorbid with migraine in children, clinically significant disease does not appear to be, though the clarity of these data is limited by overlap between migraine symptomatology and that assessed by many screening tools. Functional neurologic disorders like psychogenic non-epileptic episodes (PNEE) and other functional movement disorders are not common but can be comorbid with migraine in this population and tend to improve with migraine treatment. The number of adverse childhood experiences (ACEs) a child is exposed to seems to be near-linearly associated with risk of migraine, but not with tension-type headache (TTH).

Summary

The findings from these studies underscore the importance of utilizing appropriate screening methodologies for identifying psychiatric disorders in children with migraine. Additionally, the role of the insula, the hypothalamic–pituitary–adrenal axis, the serotonergic system, and the instability of hyperactivated neural networks may underlie the pathophysiology of both migraine and its psychiatric comorbidities.

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  1. Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Jason Ziplow

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  1. Jason Ziplow
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Correspondence to Jason Ziplow.

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This article is part of the Topical Collection on Psychological Aspects of Cardiovascular Diseases

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Ziplow, J. The Psychiatric Comorbidities of Migraine in Children and Adolescents. Curr Pain Headache Rep 25, 69 (2021). https://doi.org/10.1007/s11916-021-00983-y

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