Skip to main content

Predictors of Improvement in Pediatric Chronic Migraine: Results from the Cognitive-Behavioral Therapy and Amitriptyline Trial

Abstract

Explore predictors of improvement in headache days and migraine-related disability through a secondary analysis of the cognitive-behavioral therapy plus amitriptyline trial in children and adolescents (Clinical Trials Registration Number: NCT00389038). Participants were 135 youth aged 10–17 years old diagnosed with chronic migraine. Predictor variables included group assignment (treatment or control), baseline scores from depression and quality of life measures, and demographic variables. Criterion variables included headache days and migraine-related disability. Higher baseline depression scores were indicative of more days with headache post-treatment regardless of group assignment. Family income at the higher-end of the low-income range was significantly associated with less migraine-related disability regardless of group assignment (Household Income: HINC-01 in The United States Census Bureau. Bureau, U, 2020). Results from this secondary analysis identify depression symptoms and family income as predictors that can impact headache frequency and migraine-related disability. Self-reported symptoms of depression and family income are important factors to consider as part of the biopsychosocial model of care.

This is a preview of subscription content, access via your institution.

References

  1. Bennett, S., Shafran, R., Coughtrey, A., Walker, S., & Heyman, I. (2015). Psychological interventions for mental health disorders in children with chronic physical illness: A systematic review. Archives of Disease in Childhood, 100, 308–316. https://doi.org/10.1136/archdischild-2014-307866

    Article  PubMed  Google Scholar 

  2. Buse, D. C., Manack, A. N., Fanning, K. M., Serrano, D., Reed, M. L., Turkel, C. C., & Lipton, R. B. (2012). Chronic migraine prevalence, disability, and sociodemographic factors: Results from the American migraine prevalence and prevention study. Headache the Journal of Head and Face Pain, 52(10), 1456–1470. https://doi.org/10.1111/j.1526-4610.2012.02223.x

    Article  Google Scholar 

  3. Conner, M., McEachan, R., Jackson, C., McMillan, B., Woolridge, M., & Lawton, R. (2013). Moderating effect of socioeconomic status on relationship between health cognitions and behaviors. Annals of Behavioral Medicine, 46(1), 19–30

    Article  Google Scholar 

  4. Ha, H., & Gonzalez, A. (2019). Migraine headache prophylaxis. American Family Physician, 99(1), 17–24

    PubMed  Google Scholar 

  5. Hershey, A. D. (2009). Evaluation and classification. In A. D. Hershey, S. W. Powers, P. Winner, & M. A. Kabbouche (Eds.), Pediatric headaches in clinical practice. (pp. 13–20). Wiley

    Chapter  Google Scholar 

  6. Hershey, A. D. (2010). Current approaches to the diagnosis and management of paediatric migraine. Lancet Neurology, 9, 190–204

    CAS  Article  Google Scholar 

  7. Hershey, A. D., Oskoui, M., Pringsheim, T., Holler-Managan, Y., Potrebic, S., Billinghurst, L., Gloss, D., Licking, N., Sowell, M., & Victorio, M. C. (2019). New guidelines: Interpretation, application and the future. Headache, 59(8), 1133–1143

    Article  Google Scholar 

  8. Hershey, A. D., Powers, S. W., Vockell, A. L., LeCates, S. L., Segers, A., & Kabbouche, M. A. (2004). Development of a patient-based grading scale for PedMIDAS. Cephalalgia, 24(10), 844–849

    CAS  Article  Google Scholar 

  9. Household Income: HINC-01. (2020). The United States Census Bureau. Bureau, U. (2020, August 17). Household Income: HINC-01. Retrieved January 29, 2021, from https://www.census.gov/data/tables/time-series/demo/income-poverty/cps-hinc/hinc-01.html

  10. International Classification of Headache Disorders, 3rd Edition (ICHD-3). (2018). Headache classification committee of the international headache society (IHS) the international classification of headache disorders, 3rd edition. Cephalalgia, 38(1), 1–211. https://doi.org/10.1177/0333102417738202

    Article  Google Scholar 

  11. Kovacs, M. (2004). Children’s Depression Inventory (CDI). Multi-Health Systems Inc.

    Google Scholar 

  12. Oskoui, M., Pringsheim, T., Billinghurst, L., Potrebic, S., Gersz, E. M., Gloss, D., Holler-Managan, Y., Leininger, E., Licking, N., & Mack, K. (2019a). Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Headache, 59(8), 1144–1157

    Article  Google Scholar 

  13. Oskoui, M., Pringsheim, T., Billinghurst, L., Potrebic, S., Gersz, E. M., Gloss, D., Holler-Managan, Y., Leininger, E., Licking, N., & Mack, K. (2019b). Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the guideline development, dissemination, and implementation subcommittee of the American Academy of Neurology and the American Headache Society. Neurology, 93(11), 500–509

    Article  Google Scholar 

  14. Powers, S. W., Gilman, D. K., & Hershey, A. D. (2006). Suggestions for a biopsychosocial approach to treating children and adolescents who present with headache. Headache the Journal of Head and Face Pain, 46(3), 149–150. https://doi.org/10.1111/j.1526-4610.2006.00568.x

    Article  Google Scholar 

  15. Powers, S. W., Kashikar-Zuck, S., Allen, J. R., LeCates, S. L., Slater, S. K., Zafer, M., Kabbouche, M. A., O'Brien, H. L., Shenk, C. E., Rausch, J. R., & Hershey, A. D. (2013). Cognitive behavioral therapy plus amitriptyline for chronic migraine in children and adolescents: A randomized clinical trial. The Journal of the American Medical Association, 310(24), 2622–2630

    CAS  Article  Google Scholar 

  16. Schwartz, L. A., Radcliffe, J., & Barakat, L. P. (2007). The development of a culturally sensitive pediatric pain management intervention for African American adolescents with sickle cell disease. Journal of Child Health Care, 36(3), 267–283. https://doi.org/10.1080/02739610701377954

    Article  Google Scholar 

  17. Varni, J. W., & Limbers, C. A. (2009). The pediatric quality of life inventory: Measuring pediatric health-related quality of life from the perceptive of children and their parents. Pediatric Clinics of North America, 56(4), 843–863. https://doi.org/10.1016/j.pcl.2009.05.016

    Article  PubMed  Google Scholar 

  18. Winner, P. (2009). Pediatric and adolescent migraine. American Headache Society.

    Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Eman K. Rettig.

Ethics declarations

Conflict of interest

Eman K. Rettig, Gokce Ergun, Janeece R. Warfield, Shalonda K. Slater, Susan L. LeCates, Marielle A. Kabbouche, Joanne Kacperski, Andrew D. Hershey, Scott W. Powers declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

No human or animals were harmed during this study. This was a retrospective review of existing clinical data.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Rettig, E.K., Ergun, G., Warfield, J.R. et al. Predictors of Improvement in Pediatric Chronic Migraine: Results from the Cognitive-Behavioral Therapy and Amitriptyline Trial. J Clin Psychol Med Settings (2021). https://doi.org/10.1007/s10880-021-09782-4

Download citation

Keywords

  • Pain
  • Children
  • Adolescents
  • Depression
  • Family income
  • Migraine