This study aimed to examine the mediating role of early maladaptive schemas on the relationship between illness-related perceptions and pain coping strategies among adolescents diagnosed with ...migraine.
A total of 134 adolescents (aged 12-18 years) diagnosed with migraine with and without aura participated in the study. The Illness Perception Questionnaire, the Pain Coping Questionnaire, and the Early Maladaptive Schema Questionnaires Set for Children and Adolescents were used.
The intensity of using desperate ways of coping with pain was higher among adolescents who perceive migraine as a chronic disease (
= 0.199,
< 0.05) even if they have episodic attacks and who have higher levels of coherency in understanding the illness (
= 0.256,
< 0.01). First, full mediations of over-vigilance/inhibition and impaired autonomy/performance schema domains on these relations were observed. Second, the increases in negative cognitive (
= 0.199,
< 0.05) and emotional (
= 0.280,
< 0.01) representations related to the consequences of the illness lead to an increase in the uncontrolled and frequent use of analgesic drugs where the partial mediating role of over-vigilance/inhibition schema domain on this correlation is observed. The perceptions about the negative as well as serious consequences of migraine are related to both the self-active behaviors (
= 0.181,
< 0.05) and the conscious cognitive attempts (
= 0.207,
< 0.05) as effective coping strategies, which is an unexpected finding. The disconnection/rejection schema domain had a full mediation role on both relations.
The results suggest that early maladaptive schemas are essential factors that affect the migraine coping processes of adolescents.
Despite many diverse findings from studies about the comorbidity of psychiatric disorders and migraine, there are still unknown points. Schemas, which are the basic structures of cognition, are ...understudied. This study examined the effects of sex on early maladaptive schemas (EMSs) and the clinical characteristics of migraine in adolescents with migraine.
The sample comprised 171 adolescents (67.3% females, n = 115) aged 12–18 years. The clinical characteristics of migraine (duration, severity, frequency of headaches, etc.), accompanying symptoms (nausea, vomiting, photophobia, etc.) and EMSs were evaluated depending on sex. Psychopathology and abuse history were analyzed as covariates in this study.
The mean age was 15.4 ± 1.9 among the females and 15.2 ± 2.0 among the males (p = 0.65). There was no difference in terms of migraine characteristics, and except for dizziness and pain relief by massage, all other symptoms were similar between the sexes. Female adolescent migraineurs significantly elevated scores for EMS of emotional deprivation, abandonment/instability, defectiveness/shame (disconnection/rejection domain), dependence/incompetence, vulnerability to harm/illness, failure (in impaired autonomy/performance domain) and negativity/pessimism (in hypervigilance/inhibition domain). On the other hand, male migraineurs had significantly elevated scores only in insufficient self-control/self-discipline (in impaired limits domain). Type of migraine and current psychopathology had no significant effect on the EMS domains, while sexual abuse history significantly affected some EMS.
Our study highlights the importance of screening for EMSs among adolescent patients with migraine. Schema therapy and similar therapeutic interventions may be used in the management of migraine in adolescents. Gender may also be important factor the schema therapy in adolescent migraine patients.
Attention deficit and hyperactivity disorder (ADHD) is a neuro-developmental disorder related to internalizing and externalizing disorders as well as somatic complaints and disorders. This study was ...conducted to evaluate the prevalence of headache subtypes, epilepsy, atopic disorders, motion sickness and recurrent abdominal pain among children and adolescents with ADHD and their parents.
In a multi-center, cross-sectional, familial association study using case-control design, treatment naïve children and adolescents between 6 and 18 years of age diagnosed with ADHD according to the DSM-5 criteria as well as age- and gender-matched healthy controls and their parents were evaluated by a neurologist and analyzed accordingly.
117 children and adolescents with ADHD and 111 controls were included. Headache disorder diagnosis was common for both patients and healthy controls (59.0% vs. 37.8%), with a significantly elevated rate in the ADHD group (p = 0.002). Migraine was found in 26.0% of ADHD patients and 9.9% of healthy controls. Tension headache was found in 32.4% of ADHD patients and 27.9% of healthy controls. Headache diagnosis was also found to be significantly more common in mothers of children with ADHD than control group mothers (90.5% vs. 36.6%, p < 0.001).
Headache diagnoses and specifically migraines were significantly more common among children with ADHD and their mothers, while recurrent abdominal pain was elevated in both parents and ADHD patients. Migraine is an important part of ADHD comorbidity, not only for children but also for mothers. Motion sickness may be reduced among families of ADHD probands.
Deletion or duplication of the short arm of chromosome 9 may lead to a variety of clinical conditions including craniofacial and limb abnormalities, skeletal malformations, mental retardation, and ...autism spectrum disorder. Here, we present a case report of 5-year-old boy with 9p deletion syndrome and autism spectrum disorder.
Psychotherapies, such as schema therapy, are receiving increasing attention in the management of pediatric headaches. The purpose of this study was to investigate early maladaptive schemas (EMSs) in ...adolescents with episodic migraine (EM) and chronic migraine (CM).
This clinic-based, cross-sectional study consisted of 167 adolescents, aged 12-18, who were diagnosed with EM (
= 140) and CM (
= 27). The clinical characteristics of migraine, its accompanying symptoms, EMSs, the interrelationship of EMSs, depression, and anxiety were evaluated. We specifically analyzed psychopathology and abuse history as covariates in this study.
Defectiveness/shame, mistrust/abuse, abandonment/instability, enmeshment/undeveloped self, self-sacrifice, and subjugation schemas were more prevalent in the CM group. In terms of schema domains, the CM group scored significantly higher in disconnection/rejection and other orientations. Psychopathology did not affect the EMS scores, but a history of sexual abuse did. In patients with EM, a relationship was found between the variables of anxiety, depression, and five of the EMS domains. On the other hand, the CM group showed a significant relationship with anxiety, hypervigilance/inhibition, disconnection/rejection, and other orientation domains.
This study highlights the value of EMSs, anxiety, and depression in young people with EM and CM. Schema therapy and schema-based therapeutic interventions should be researched, especially in pediatric migraine, as they may potentially prevent the progression to treatment-resistant migraine.
Managing treatment-resistant obsessive-compulsive disorder (TR-OCD) is often a challenge for clinicians, especially when adolescents and children are the patients. Approximately one-quarter to ...one-third of children with OCD do not respond to first-line treatments. Studies on the combination of venlafaxine and mirtazapine in children and adolescents are promising, but there is insufficient information about the use of this combination in TR-OCD. As far as we know, this is the first report of an adolescent patient with TR-OCD who responded favorably to a combination of a serotonin-norepinephrine reuptake inhibitor (venlafaxine), an alpha-2 adrenergic receptor antagonist (mirtazapine), and an atypical antipsychotic (aripiprazole). This case provides an example of the effective and safe use of the venlafaxine, mirtazapine, and aripiprazole given in combination in an adolescent with TR-OCD.
Psychiatr Ann
. 2020;50(11):509–512.
Background
The supportive clinical and pathophysiological data about the correlation between migraine and atopic disorders are far from a coincidence. In order to determine and investigate the ...correlates of atopic disorders in a specific dataset, we performed this retrospective cross‐sectional clinical‐based study.
Methods
The dataset was composed from three tertiary center web‐based databases (http://www.childhoodheadache.org). Headache diagnosis and differential diagnosis were made according to the International Classification of Headache Disorders, 2nd version and the Diagnostic Statistical Manual of Mental Disorders, 5th edition. Migraine with aura, migraine without aura, chronic migraine and episodic and chronic tension type headache (TTH) patients were included. All other causes of headache disorders, including comorbid headache disorders like migraine plus TTH or “possible” causes of headache, were excluded.
Results
The study included 438 patients with migraine and 357 patients with TTH, whose age and sex distribution were identical. After descriptive statistics accordingly, 80 migraine (18.2%) and 23 TTH (6.4%) patients were found to have specific atopic disorders (P < 0.001). Atopic disorders are more commonly reported in patients with migraine with aura (21.6%) than those with migraine without aura and TTH (P < 0.001). The most common atopic disorders were seasonal rhinitis, conjunctivitis and asthma. There was also a close correlation between TTH with atopic disorders and psychiatric comorbid disorders of the patients.
Conclusions
Although the International Classification of Headache Disorders, 2nd version, does not specify, atopic disorders should be suspected in all migraine patients and their relatives, not only for accurate diagnosis but also for planning prophylactic medications, such as β‐blockers.
Conversion disorder is defined as the loss or change of motor, sensory, and autonomic nervous system-related functions that cannot be explained completely with organic causes. The etiology of the ...disease may be explained by psychoanalytic theory, learning theory, sociocultural factors, and some traumatic life events besides genetic and neurobiological factors. The onset is usually between late childhood and early adulthood. The disorder occurs after a high rate of psychosocial stressors and the symptoms can vary. While astasia, as one of the possible complaints in conversion disorder, is defined as not being able to stand due to loss of motor power or sensory loss; abasia is identified as patients having no apparent motor problem but not being able to walk properly. Both conditions can be of organic as well as the psychogenic origin. In this paper, the clinical signs of a seven-year-old boy who was admitted to emergency service of Mersin University Faculty of Medicine with the complaints of astasia and abasia but was found to have conversion disorder is presented. The results of the medical examinations and the possible psychosocial stress factors behind these symptoms, as well as the treatment process of the case, were shared. With this report, we is aimed to draw attention to the importance of early diagnosis of the disorder, the necessity of an interdisciplinary approach in the treatment process, and the handling of psychosocial factors leading to somatic symptoms.
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