Skip to main content

Advertisement

SpringerLink
Log in

Kopfschmerz bei Kindern und Jugendlichen

Epidemiologie, biopsychosoziale Korrelate und psychologische Behandlung

Headache in children and adolescents

Epidemiology, biopsychosocial correlates, and psychological treatment approaches

  • Leitthema
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Epidemiologie

Eine Reihe von Studien hat übereinstimmend gezeigt, dass Kopfschmerz der häufigste Schmerztyp bei Kindern und Jugendlichen ist. Wöchentlich auftretender Schmerz wird von mehr als 10 % der Betroffenen berichtet. Die Anzahl der Betroffenen mit einer hohen Beeinträchtigung ist aber geringer als erwartet (~ 4 %).

Zusammenhang mit biopsychosozialen Faktoren

Kopfschmerz ist eng verbunden mit Schmerz in anderen Körperregionen. Körpersymptome verschiedener anderer Art begleiten Kopfschmerz, ebenso wie chronische Krankheiten. Verschiedene Merkmale wie dysfunktionale psychologische Eigenschaften, insbesondere die sog. internalisierenden Symptome, sind eng mit Kopfschmerz verzahnt. Dies gilt in ähnlicher Weise für externalisierende Symptome. Katastrophisierung genauso wie somatosensorische Amplifikation und Angstsensitivität charakterisieren viele der betroffenen Kinder. Auch Faktoren der sozialen Umwelt wie kritische Lebensereignisse, schulbezogene und familiäre Stressoren, ebenso wie sozioökonomische Faktoren können Risikofaktoren darstellen.

Psychologische Interventionen

Entspannungstraining, Biofeedback und kognitiv-behaviorale Programme haben sich in verschiedenen Metaanalysen als wirksam erwiesen. Die Letzteren sind auch in Gruppentrainings eingesetzt worden und in jüngerer Zeit in Selbsthilfeprogrammen, vermittelt über elektronische Medien. Das Ziel dieser Programme ist die Prävention zukünftiger Kopfschmerzattacken auf der Basis der Stärkung der von Selbstwirksamkeitserwartungen sowie der Vermittlung von Bewältigungsstrategien. Diese Kompetenzen sollen zu einer langfristigen erfolgreichen Verhinderung eines negativen Verlaufs der Störung im Erwachsenenalter beitragen.

Abstract

Epidemiology

An abundance of studies have consistently shown that headache is the most prevalent pain in children and adolescents. Weekly headache is experienced by more than 10 % and is distinctly more frequent in girls. The number of headache-affected youths with high disability is lower than expected (~ 4 %).

The association with biopsychosocial factors

Headache is associated with pain in other body sites, thus multiple pain is experienced more often than isolated headache. Various somatic symptoms and even chronic diseases are also correlated with headache. Headache in parents carries a high risk of also occurring in their children. Various other psychosocial factors such as dysfunctional psychological traits are closely linked with headache, the most prominent being internalizing symptoms. However, externalizing symptoms also correlate with headache. Pain catastrophizing, as well as somatosensory amplification and anxiety sensitivity, have been shown to characterize individuals with headache. Features of the social environment, such as life events, school, as well as family stressors and socioeconomic parameters, are among the risk factors.

Psychological interventions

Psychological interventions such as biofeedback, relaxation, and cognitive-behavioral training have proved their efficacy in headache treatment according to several meta-analyses. The latter has also been conducted in group settings and more recently in self-management focused trainings using electronic media. They mainly aim at the prevention of further headache episodes. The goal of this training is the strengthening of self-efficacy beliefs and active coping strategies. It is proposed that these competencies could contribute to the successful long-term prevention of an adverse course of headache into adulthood.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Ghandour RM, Overpeck MD, Huang ZJ, Kogan MD, Scheidt PC (2004) Headache, stomachache, backache, and morning fatigue among adolescent girls in the United States: associations with behavioral, sociodemographic, and environmental factors. Arch Pediatr Adolesc Med 158:797–803

  2. Sillanpää M (1976). Prevalence of migraine and other headache in Finnish children starting school. Headache 15:288–290

  3. Sillanpää M, Anttila P (1996) Increasing prevalence of headache in 7-year-old schoolchildren. Headache 36:466–470

  4. Luntamo T, Sourander A, Santalahti P, Aromaa M, Helenius H (2012) Prevalence changes of pain, sleep problems and fatigue among 8-year-old children: years 1989, 1999, and 2005. J Pediatr Psychol 37:307–318

  5. Bille B (1982) Migraine in childhood. Panminerva Med 71:57–62

  6. Kröner-Herwig B, Heinrich M, Morris L (2007) Headache in German children and adolescents: a population-based epidemiological study. Cephalalgia 27:519–527

  7. King S, Chambers CT, Huguet A, MacNevin RC, McGrath PJ, Parker L, MacDonald AJ (2011) The epidemiology of chronic pain in children and adolescents revisited: a systematic review. Pain 152:2729–2738

  8. Kröner-Herwig B, Gaßmann J (2012) Headache disorders in children and adolescents: their association with psychological, behavioral, and socio-environmental factors. Headache 52:1387–1401

  9. Kröner-Herwig B, Heinrich M, Vath N (2010) The assessment of disability in children and adolescents with headache: adopting PedMIDAS in an epidemiological study. Eur J Pain 14:951–958

  10. Kröner-Herwig B, Gaßmann J, van Gessel H, Vath N (2011) Multiple pains in children and adolescents: a risk factor analysis in a longitudinal study. J Pediatr Psychol 36:420–432

  11. Kröner-Herwig B, Hechler T, Zernikov B (2013) Chronischer Schmerz. In: Lohaus A, Heinrich N (Hrsg) Chronische Erkrankungen im Kindes- und Jugendalter. Beltz, Weinheim, S 174–186

  12. Egger HL, Angold A, Costello EJ (1998) Headaches and psychopathology in children and adolescents. J Am Acad Child Adolesc Psychiatry 37:951–958

  13. Passchier J, Orlebeke JF (1985) Headache and stress in school children: an epidemiological study. Cephalalgia 5:167–176

  14. Fritsche G, Kröner-Herwig B, Kropp P, Niederberger U, Haag G (2013) Psychologische Therapie der Migräne – Systematische Übersicht. Schmerz 2:263–274

  15. Kröner-Herwig B (2011) Psychological treatments for pediatric headache. Expert Rev Neurother 11:403–410

  16. Headache Classification Committee of the International Headache Society (1988) The international classification of headache disorders, classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalalgia 8:1–96

  17. Heinrich M, Morris L, Kröner-Herwig B (2009) Self-report of headache in children and adolescents in Germany: possibilities and confines of questionnaire data for headache classification. Cephalalgia 29:864–872

  18. Kröner-Herwig B, Morris L, Heinrich M, Gaßmann J, Vath N (2009) Agreement of parents and children on characteristics of pediatric headache, other pains, somatic symptoms, and depressive symptoms in an epidemiologic study. Clin J Pain 25:58–64

  19. Santalahti P, Aromaa M, Sourander A, Helenius H, Piha J (2005) Have there been changes in children’s psychosomatic symptoms? A 10-year comparison from Finland. Pediatrics 115:434–442

  20. Clancy CA, McGrath PJ, Oddson BE (2005) Pain in children and adolescents with spina bifida. Dev Med Child Neurol 47:27–34

  21. Van Gessel H, Gassmann J, Kröner-Herwig B (2011) Children in pain: recurrent back pain, abdominal pain, and headache in children and adolescents in a four-year-period. J Pediatr 158:977–983

  22. Headache Classification Committee of the International Headache Society (2004) The international classification of headache disorders, 2nd ed. Cephalalgia 24(Suppl 1):9–160

  23. Laurell K, Larsson B, Eeg-Olofsson O (2004) Prevalence of headache in Swedish schoolchildren, with a focus on tension-type headache. Cephalalgia 24:380–388

  24. Bener A, Uduman SA, Quassimi M, Khalaily G, Szthriha L, Kilpelainen H, Obineche E (2000) Genetic and environmental factors associated with migraine in schoolchildren. Headache 40:152–157

  25. Rhee H (2000) Prevalence and predictors of headaches in US adolescents. Headache 40:528–538

  26. Barea LM, Tannhauser M, Rotta NT (1996) An epidemiologic study of headache among children and adolescents of southern Brazil. Cephalalgia 16:545–549

  27. Wang EY, Fuh JL, Lu SR, Juang KD (2006) Chronic daily headache in adolescents – prevalence, impact, and medication overuse. Neurology 66:193–197

  28. Zwart JA, Dyb G, Holmen TL, Stovner LJ, Sand T (2004) The prevalence of migraine and tension-type headaches among adolescents in Norway. The Nord-Trøndelag Health Study (Head-HUNT-Youth), a large population-based epidemiological study. Cephalalgia 24:373–379

  29. Kröner-Herwig B, Vath N (2009) Menarche in girls and headache – a longitudinal analysis. Headache 49:860–867

  30. Aromaa M, Sillanpää M, Rautava P, Helenius H (2005) Pain experience of children with headache and their families: a controlled study. Pediatrics 106:270–275

  31. Fichtel A, Larsson B (2002) Psychosocial impact of headache and comorbidity with other pains among Swedish school adolescents. Headache 42:766–775

  32. Kröner-Herwig B (2013) Pediatric headache: associated psychological factors and psychological treatment. Curr Pain Headache Rep 17:1–9

  33. Balottin U, Poli PF, Termine C, Molteni S, Galli F (2013) Psychopathological symptoms in child and adolescent migraine and tension-type headache: a meta-analysis. Cephalalgia 33:112–122

  34. Guidetti V, Galli F (1998) Evolution of headache in childhood and adolescence: an 8-year follow-up. Cephalalgia 18:449–454

  35. Blackman JA, Gurka MJ, Gurka KK, Oliver MN (2011) Emotional, developmental and behavioural co-morbidities of children with chronic health conditions. J Paediatr Child Health 47:742–747

  36. Norton PJ, Asmundson GJ (2004) Anxiety sensitivity, fear, and avoidance behavior in headache pain. Pain 111:218–223

  37. Barsky AJ, Goodson JD, Lane RS, Cleary PD (1988) The amplification of somatic symptoms. Psychosom Med 50:510–519

  38. Kröner-Herwig B, Maas J (2013) The German Pain Catastrophizing Scale for Children (PCS-C) – psychometric analysis and evaluation of the construct. Psychosoc Med 10:ArtID Doc 07

  39. Kato K, Sullivan PF, Evengard B, Pedersen NL (2009) A population-based twin study of functional somatic syndromes. Psychol Med 39:497–505

  40. Kröner-Herwig B, Mohn U, Pothmann R (1998) Comparison of biofeedback and relaxation in the treatment of pediatric headache and the influence of parent involvement on outcome. Appl Psychophysiol Biofeedback 23:143–157

  41. Trautmann E, Lackschewitz H, Kröner-Herwig B (2006) Psychological treatment of recurrent headache in children and adolescents – a meta-analysis. Cephalalgia 26:1411–1426

  42. McGrath PJ, Unruh AM (1987) Pain in children and adolescents. Pain research and clinical management. Elsevier Science Technology Books, Amsterdam

  43. Denecke H, Kröner-Herwig B (2000) Kopfschmerz-Therapie mit Kindern und Jugendlichen – Ein Trainingsprogramm. Hogrefe, Göttingen

  44. Kröner-Herwig B, Denecke H (2002) Cognitive-behavioral therapy of pediatric headache. Are there differences in efficacy between a therapist-administered group training and a self-help format? J Psychosom Res 53:1107–1114

  45. Kröner-Herwig B, Denecke H (2007) Die Behandlung von Kopfschmerz bei Kindern und Jugendlichen: Eine Praxisstudie. Verhaltensther Verhaltensmed 28:373–385

  46. Kröner-Herwig B (2013) Stopp den Kopfschmerz. Das Selbsthilfetraining für Kinder und Jugendliche. http://www.stopp-den-kopfschmerz.de. Zugegriffen: 26. Nov. 2013

  47. Trautmann E, Kröner-Herwig B (2010) A randomized controlled trial of internet-based self-help training for recurrent headache in childhood and adolescence. Behav Res Ther 48:28–37

  48. Connelly M, Rapoff MA, Thompson N, Connelly W (2006) Headstrong: a pilot study of a CD-ROM intervention for recurrent pediatric headache. J Pediatr Psychol 31(7):737–747

  49. Hicks CL, von Baeyer CL, McGrath PJ (2006) Online psychological treatment for pediatric recurrent pain: a randomized evaluation. J Pediatr Psychol 31:724–736

  50. Seemann H, Franck G, Ochs M, Verres R, Schweitzer J (2002) Chronifizierungsprävention primärer Kopfschmerzen bei Kindern und Jugendlichen. Evaluation einer lösungsorientierten Gruppentherapie in der ambulanten Versorgung. Kindheit Entwickl 11(3):185–197

  51. Ochs M, Seemann H, Bader U, Miksch A, Franck G, Verres R, Schweitzer J (2002) Primäre Kopfschmerzen im Kindes- und Jugendalter. Die Veränderung familiärer Beziehungsmuster als Korrelat des Therapieerfolgs. Schmerz 16(3):179–185

  52. Gerber WD, Petermann F, Gerber-von Müller G, Niederberger U, Rentmeister B, Siniatchkin M, Stephani U (2010) MIPAS-Family – Entwicklung und Evaluation eines verhaltensmedizinischen Programms zur Behandlung kindlicher Kopfschmerzen. Verhaltenstherapie 18(4):247–255

  53. Eccleston C, Palermo TM, de C Williams AC, Lewandowski A, Morley S, Fisher E, Law E (2009) Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev (2):CD003968

  54. Sarafino EP, Goehring P (2000) Age comparisons in acquiring biofeedback control and success in reducing headache pain. Ann Behav Med 22:10–16

Download references

Einhaltung ethischer Richtlinien

Interessenkonflikt

B. Kröner-Herwig gibt an, dass kein Interessenkonflikt besteht und die Einhaltung aller relevanten ethischen Richtlinien befolgt wurde.

Author information

Authors and Affiliations

  1. Abteilung für Klinische Psychologie und Psychotherapie, Georg-August-Universität Göttingen, Goßlerstraße 14, 37073, Göttingen, Deutschland

    B. Kröner-Herwig

Authors
  1. B. Kröner-Herwig
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B. Kröner-Herwig.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kröner-Herwig, B. Kopfschmerz bei Kindern und Jugendlichen. Bundesgesundheitsbl. 57, 928–934 (2014). https://doi.org/10.1007/s00103-014-1999-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00103-014-1999-z

Schlüsselwörter

Keywords

Search

Navigation