Attachment Characteristics of Children with Primary Headache and Their Mothers, and Comparison of Psychiatric Comorbidity and Intelligence Levels of the Children

Objective: This observational study aimed to investigate comorbid psychiatric disorders and patterns of attachment among children and adolescents diagnosed with primary headaches. We also aimed to study the relationship between maternal attachment and headache. Material and Method: The study included 34 patients (50% girls) aged 6-16 years (mean age = 10.8 ± 2.3 years) who were under the care of pediatric clinics, as well as their 34 mothers. Psychiatric disorders were evaluated among the participants using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version, based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Diagnosis of primary headaches in accordance with the requirements of the International Classification of Headache Disorders, second edition. The child participants were assessed using the Short Form of the Inventory of Parent and Peer Attachment (IPPA) and the Wechsler Intelligence Scale for Children- Revised Intelligence Quotient (WISC-R IQ), and their mothers completed the Experiences in Close Relationships (ECR) Inventory and Symptom Check List-90-Revised (SCL-90-R). Results: The results of the neurological assessments of the children with headache showed that 20 were diagnosed with migraine, 9 were diagnosed with other primary headache, and 5 were diagnosed with tension-type headache. The mean scores of the children were 66.2±11.7 on IPPA (mother), and 62.6±11.7 on IPPA (father), and the mean scores of the mother were 66.1±15.0 on ECR (avoidance), 66.7±16.7 on ECR (anxious). No significant differences were observed in these scales according to headache subtype. According to the results of the psychiatric evaluations, specific learning disability, attention deficit-hyperactivity disorder, phobias, and separation anxiety were found the most frequently, and in the comparisons made between the frequencies of mental diagnoses in the children and those in the general population. The children had a mean overall WISC-R IQ score of 96.4 ±15.0, which indicated normal intelligence. There were no significant differences in psychiatric comorbidity rates or WISC-R IQ mean scores according to headache subtype. Conclusion: Children with headaches should be evaluated by a psychiatrist and neurologist and treated accordingly.