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Shocking News: Kids with Migraine Have “Behavior Problems”

Children and teenagers with severe headaches are more likely than others to have “emotional, behavioral and social problems,” according to a study published in the May issue of Pediatrics. From these findings, researchers are now asking about the correlation: Do the headaches lead to behavior problems or do the behavior problems lead to headaches?

Surely they can see that headache pain changes someone’s behavior. It’s both common sense and physiological fact.

Head pain = being grumpy, short tempered, angry, foggy headed, etc.

In addition, among the myriad symptoms of migraine — and I think of other headaches too — is altered behavior. According to the American Council for Headache Education‘s book Migraine: The Complete Guide some of these are mood changes, irritability, high energy and lethargy. Other symptoms that could change behavior include mental confusion, disorientation, transient global amnesia (similar to amnesia that follows a concussion), difficulty finding words, and problems understanding spoken or written language.

I know my behavior and attitudes change. I am often high strung right before a migraine and can be off kilter for a few days while I’m dealing with headache hangover. I also know that many of you have the same experiences.

Yes, yes, researchers don’t believe something to be “true” until studies shows that it is, but come on.

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Losing Sleep Connected to CDH & Migraine

Two-thirds of kids with CDH also have sleep disturbances, reported a study presented at last week’s Annual Conference on Sleep Disorders. Although the study is about kids, the findings seem to be applicable to adults.

Researchers were surprised by their findings. Kenneth Mack, one of the researchers, said: “The number of patients who have headaches and also sleep disturbance surprised us. They also have the same sleep disturbance: a delay in sleep onset.”

Even though people with CDH and migraine are probably not astonished by this news, it’s still significant. Until someone identifies something as a problem, it’s not considered a issue, particularly in medicine. Once a topic is studied and the results are meaningful, some doctors and nurses will start treating those symptoms. Of course, the research has to be replicated to establish the connection, but it still raises awareness of the issue.

It also encourages headache sufferers to consider whether their sleep is disturbed, which, again, is the first step in treatment. Since lack of sleep is a big headache trigger, treating it may reduce the frequency and intensity of one’s headaches.

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How Headache Affects Families

The National Headache Foundation has announced the results of their online survey to better understand how headaches affect a sufferer’s family and what role heredity plays in headache. Findings include:

  • 66% of sufferers have a family history of headache; in 63% of the cases it is the mother that has headache
  • 53% of respondents said that their families do not understand their headache condition
  • 63% of sufferers said that when they have a headache they are unable to attend to household chores such as cleaning, grocery shopping and cooking
  • 79% of family members have to cooking meals and 61% having to handle household cleaning during these periods
  • 63% of spouses or significant others take on extra household and child-rearing responsibilities during a sufferer’s headache
  • 68% of people with headache feel that their spouse or significant other support them when they have a headache
  • 83% of respondents feel guilty about not being able to spend time with their families
  • 66% state that they believe their families feel neglected when they have their headache attacks
  • 50% of headache sufferers feel that their spouse or significant other does not understand their headache issues and needs

From these findings and talking with other people with headache, it is clear that chronic pain can strain even the happiest of relationships. Learning to live with chronic pain can be frustrating, exhausting, exasperating and heartbreaking, for patients as well as their relational partners and families.

Coincidentally, I posted a review of Chronic Pain and the Family on Blogcritics yesterday. The book explores the issues facing couples (as well as children and extended family) who have to deal with one person’s illness. The author offers suggestions for each person in the couple to repair the relationship and shares many additional sources to help couples and families. She also explains the debility associated with chronic pain and the havoc it wreaks on people in pain.

An excerpt from the book is available from the publisher, Harvard University Press.

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News Roundup

It’s a busy day and there’s a lot of news from today and from the week that I have blogged about, so here are headlines and excerpts. They’re in reverse chronological order. I can’t shake the feeling that I’ve missed something. If you know of other relevant news, please post it in the comments. Thanks!

Self Reported Chronic Pain in School Age Children
“The results showed an incredible prevalence of chronic pain (defined as pain for longer than 3 months) at 44% of all responders. Headache was the most common source of pain (38%) closely followed by back pain (17%) and limb pain (15.7%). The effects on daily living tended to impact most significantly on ability to pursue hobbies (girls 60%, boys 57%); sleeping problems (girls 61%, boys 46%); eating problems (girls 48%, boys 30%) as well as numerous other normal adolescent activities.”

Pain, Fear of Pain and Expectancy as Indicators of Future Disability
In a study of people with chronic back pain, “…negative expectancies were associated with frequent pain and a belief that their condition was derived from a serious underlying medical problem. Patients with negative expectancy and a fear that activity might result in further injury, re-injury or increased pain, displayed significant differences in suffered pain and functional capacity at one year than those with a positive perspective and no fear.”

(I hate when folks assume that pain is caused or perpetuated by attitude, but I can see how expectations can play a role in perpetuating or increasing pain.)

Cigna Offers its Customers Drug Data
Cigna “…has set up a Web site to help its customers find the lowest prices charged by pharmacies for prescription drugs. The site shows prices, including the patient’s out-of-pocket spending, for 52,000 pharmacies nationwide, as well as for mail- order or home-delivery service, the Philadelphia-based company insurer said. Consumers also can compare the costs of brand-name medicines with generic copies.”

(via Kaiser Networks’ daily reports)

Wall Street Journal Examines Efforts by Pharmaceutical Companies To ‘Revamp’ Image
“The Wall Street Journal on Friday examined efforts by pharmaceutical companies to ‘revamp their image’ in response to consumer criticism over high prices, safety concerns and ‘aggressive’ advertising. Opinion polls indicate that consumers consider the pharmaceutical industry to be one of the ‘least trusted’ industries….”

Wall Street Journal Examines Evaluations of Clinical Trials by Health Insurers, Others
“The Wall Street Journal on Wednesday examined research by insurers, state Medicaid programs and not-for-profit groups to evaluate clinical trials for prescription drugs and identify any ‘marketing spin’ included in studies published in medical journals.”

Drug Trials and the Media
“Media reports of drug trials can lack accuracy and reliability, according to a study published in the open access journal BMC International Health and Human Rights. Researchers say that in controversial issues such as HIV/AIDS prevention drug trials, investigators and funders should engage with the media to avoid misinterpretation and inaccurate reporting.”

(This is specifically about HIV/AIDS drug trials, but the issues are relevant throughout drug trials.)

Understanding the Relationship Between Pain, Impairment and Physical Disability
“The association between pain, impairment and disability is frequently observed in clinical practice but the relationship is not as straight-forward as just one to one; for example some patients may have severe pain but little impairment. Consequently, a group of investigators from University of Bergen in Norway set about trying to establish a more concrete idea of the interaction between these relative dimensions to quality of life.”

St. Jude Medical Announces IDE Approval to Begin ESCAPE Migraine Study
“St. Jude Medical believes it is the first company to receive FDA conditional approval to study the potential connection between Patent Foramen Ovale (PFO) closure and migraine headaches. A PFO is a structural defect of the heart where a small hole between the right and left atria (upper chambers of the heart) fails to close in infancy. An estimated 25% of the adult population has a PFO but in most people it is usually considered benign.

…The objective is to determine if patients who undergo a PFO closure procedure have a decreased number of migraines over a one year follow-up period as compared to those who are maintained only on drug therapy. Enrollment in the study is expected to begin by the end of 2005.”

First Detailed Picture of Migraine Attack
“Using a new method, researchers at Göteborg have managed for the first time ever to provide a detailed picture of an untreated attack. This will be of great significance for the development of new forms of treatment.”