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Management of children and young people with headache
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  • Published on:
    Reply to: Psychological Interventions have a place in Management of Paediatric Headache
    • William Whitehouse, Dr Division of Academic Child Health, School of Medicine, E Floor East Block, Queen's Medical Centre, Nottingham NG7 2UH, UK

    Reply to: Psychological Interventions have a place in Management of Paediatric Headache
    Michael J Morton, Honorary Clinical Senior Lecturer in Child & Adolescent Psychiatry, University of Glasgow

    We are very grateful to Dr Morton for highlighting the importance of CBT and other psychological / talking therapies for children and young people with headaches, and for drawing our attention to the recent systematic review by Ng et al. Where resources exist and permit referral, this can be offered as an adjunct to acute / rescue treatment advice and as an alternative or adjunct to preventative drug therapies and acupuncture for migraine, and may be transformative for worrying tension-type headaches. Even for the trigeminal autonomic cephalalgias (including paroxysmal hemicranias) and idiopathic stabbing headache, CBT and psychological support for the child and young person and their family and carers can be really helpful. Where access to psychological interventions is difficult or inadequate, we should still request it and support the development of these crucial services. Thank you for this important contribution.

    William Whitehouse and Shakti Agrawal

    Conflict of Interest:
    None declared.
  • Published on:
    Psychological Interventions have a place in Management of Paediatric Headache
    • Michael J Morton, Honorary Clinical Senior Lecturer in child & Adolescent Psychiatry University of Glasgow

    The management of headache should be imbued with a psychological understanding that is not sufficiently emphasised in the ADC review by Whitehouse & Agrawal. Like all pain disorders, headache has an important psychological component, which should be acknowledged as part of the assessment in order to open up a conversation that may lead to an effective non-pharmacological intervention. The recent review of treatments for paediatric migraine (Ng et al, 2017) confirms the power of one specific model of intervention in relation to one specific headache diagnosis. A creative use of mental health expertise in the Headache Clinic has the potential to change practice in relation to a range of presentations.

    A Systematic Review and Meta-analysis of the Efficacy of Cognitive Behavioral Therapy for the Management of Pediatric Migraine
    Qin Xiang Ng, MBBS; Nandini Venkatanarayanan, BMedSci, BMBS; Lakshmi Kumar, MBBS
    Headache, 2017;57(3):349-362.

    Conflict of Interest:
    None declared.