Background & Aims
There have been reports of patients visiting headache clinics in single centers, but few multicenter studies, especially involving children and adolescents, have been conducted in Japan. This study aimed to prospectively evaluate the differences between children/adolescents and adults of clinical characteristics of patients presenting to headache clinics with headache disorders in three different settings: a university hospital, a regional headache center, and a private headache clinic.
Methods
We evaluated the clinical characteristics of 2,378 patients with headache disorders (377 children/adolescents, 2,001 adults) visiting one of the three headache clinics between March 2021 and March 2022. Baseline demographics, such as the visual analog scale (VAS), and psychiatric assessments, such as the Japanese version of the Generalized Anxiety Disorder-7 (GAD-7) and the Japanese version of the Patient Health Questionnaire-9 (PHQ-9), were collected.
Results
There were significantly fewer females (62%), more migraine (85%), and fewer tension-type headaches (TTH) (8%) in children/adolescents compared to the adults (68%: p=0.03, 77%, 13%). The VAS score did not differ significantly between children/adolescents and adults (65.2, vs 64.3), but those with TTH were significantly higher in children/adolescents than in adults (59.4 vs 49.2; p=0.003). The GAD-7 score was significantly lower in children/adolescents than in adults (4.6 vs 5.9; p<0.001), and in those with migraine (4.4 vs 6.0; p<0.001), but did not show a significant difference in those with TTH. The PHQ-9 score was significantly lower in children/adolescents than in adults (5.9 vs 6.2; p=0.020), and in those with migraine (5.7 vs 6.3; p-0.020), but was significantly higher in those with TTH (7.9 vs 5.7; p=0.026).
Conclusions
This multicenter study revealed significant differences between children/adolescents and adults in various clinical settings in Japan. Pediatric patients had a distinct profile characterized by fewer females, a higher prevalence of migraine, and a lower incidence of TTH. Notably, pain severity as measured by the VAS was comparable between age groups overall, but children/adolescents with TTH reported significantly higher scores than adults, highlighting the unique pain experience in this subgroup. Psychiatric assessments using the GAD-7 and PHQ-9 revealed interesting patterns. Children/adolescents had lower anxiety and depression scores, particularly in migraine cases. However, those with TTH had higher PHQ-9 scores compared to adults, suggesting nuanced psychological implications in this specific subgroup. These findings underscore the importance of recognizing age- and subtype-specific variations in headache presentation.
References
1. Nagaseki Y, Kawamura R and Nagaseki K. A survey of patients with chronic headache in outpatient hospitals and clinics in Japan (in Japanese). Jpn J Headache 2019; 46: 154–159.
2. Ishii R, Fukazawa R, Shinomoto M, et al. Comparisons among the headache patient’s background in three different hospital (in Japanese). Jpn J Headache 2018; 45: 429.
Presenting Author
Noboru Imai
Poster Authors
Topics
- Epidemiology