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Cephalalgia. 2013 Dec;33(16):1311-8. doi: 10.1177/0333102413495966. Epub 2013 Jul 4.

Psychopathology in children and adolescents with primary headaches: categorical and dimensional approaches.

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  • 1Psychiatry Unit, Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neurosciences and Sense Organs of the "Aldo Moro" University of Bari, Italy.



Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children.


The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment.


The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments.


Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders.


The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research.


Primary headache; children; migraine; psychiatric comorbidity; tension-type

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