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Subsume Pediatric Headaches in Psychiatric Disorders? Critiques on Delphic Nosology, Diagnostic Conundrums, and Variability in the Interventions

  • Childhood and Adolescent Headache (S Evers, Section Editor)
  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

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.

Summary

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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Authors and Affiliations

  1. Department of Neuroscience, University of Pittsburgh, Pittsburgh, PA, USA

    Aditya Sharma

  2. Department of Psychology, Christ University, Delhi, NCR, India

    Priyal Khurana

  3. Department of Pediatric Neurology, Geisinger Health System, Danville, PA, USA

    Akila Venkatraman

  4. Southwood Psychiatric Hospital, Pittsburgh, PA, USA

    Mayank Gupta

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A.S, P.K and M.G wrote the main manuscript text. A.V. prepared tables and figures and contributed to the discussion section. M.G and A.V reviewed the manuscript.

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Correspondence to Mayank Gupta.

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Sharma, A., Khurana, P., Venkatraman, A. et al. Subsume Pediatric Headaches in Psychiatric Disorders? Critiques on Delphic Nosology, Diagnostic Conundrums, and Variability in the Interventions. Curr Pain Headache Rep (2024). https://doi.org/10.1007/s11916-024-01225-7

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