Psychiatric comorbidity may affect the quality of life in pediatric migraine patients, independently of pain frequency and PedMIDAS score

Abstract

Background: Migraine is a prevalent neurological disorder in children, often accompanied by psychiatric comorbidities (PC) such as depression, anxiety, and attention deficit hyperactivity disorder (ADHD). These conditions significantly affect children’s lives, particularly their self-esteem, social relationships, and overall quality of life (QOL). However, research on the combined impact of migraine and PC on pediatric QOL remains limited.

Methods: This study included 175 children aged 8–17 years from the Pediatric Neurology Outpatient Clinic of a tertiary hospital. Among them, 75 were diagnosed with migraine and 100 served as controls. Data on sociodemographic factors, migraine-related disability (PedMIDAS), PC, and QOL (KINDLR questionnaire) were collected.

Results: Major depression, ADHD, and oppositional defiant disorder were significantly more prevalent in the migraine group compared to controls. Children with episodic migraine and PC had markedly lower self-esteem, poorer social relationships, and overall QOL than those without comorbidities. Conversely, no significant QOL differences were observed between children with and without PC in the chronic migraine group. Furthermore, no correlation was found between PedMIDAS scores and QOL in migraine patients. Psychiatric comorbidities were associated with lower QOL in children with migraine, particularly in those with episodic migraine, with notable reductions in self-esteem and social relationships. PedMIDAS, while useful for assessing migraine-related disability, may not fully reflect the QOL differences associated with PC.

Conclusion: Comprehensive evaluation of both QOL and PC is essential for effective management and follow-up of pediatric migraine patients.