소아 반복성 두통 환자에서 우울, 불안 성향과 행동이상

Dep ressive and Anxious Tendency and Behavioral Abnormalities of Children Suffering from Recurrent Head ache

목 적 : 소아청소년기의 두통은 흔한 질병이며 이 시기의 반복성 두통 환자에서 행동장애 또는 심리적 장애가 동반되는 경우가 있으나 이에 대한 연구가 부족하다. 저자들은 반복성 두통을 주소로 내원한 환자들을 대상으로 하여 행동적, 심리적 성향에 대해 연구하였다. 방 법 : 2006년 1월부터 2007년 7월까지 본원 소아청소년과에서 입원 또는 통원 치료를 받은 9세 이상의 반복성 두통 환자 120명과 대조군으로 비두통 환자 33명을 대상으로 하였다. 대상 아동 전체에게 아동·청소년 행동평가척도, 소아우울척도, 소아특성불안척도, 소아상태불안척도를 시행하여 결과를 비교하였다. 결 과 : 본 연구 결과 소아청소년기의 반복성 두통 환자에서 대조군과 비교하여 총 문제 행동 점수, 내재화 점수, 외현화 점수와 우울, 특성 불안, 상태 불안 점수가 의미 있게 높았다. 총 문제 행동, 내재화, 외현화 점수와 우울, 특성 불안, 상태 불안 점수는 편두통과 긴장성 두통 간에 유의한 차이가 없었다. 결 론 : 소아 두통 환자를 치료하는 데 있어 두통 증상과 함께 우울, 불안 성향과 행동학적 이상에 대한 치료를 같이하여 환자들의 삶의 질을 높일 수 있을 것으로 사료된다.

Purpose : Headache is a common disorder in childhood and adolescence and frequently associated with emotional or psychological problems. In this study we studied behavioral and psychological characteristics of recurrent headache patients. Methods : We evaluated 120 patients over 9 years old with headache who visited Kangnam Sacred Heart Hospital. 33 patients who didn't have headache were included in the control group. Diagnosis was confirmed according to ICHD-2 classification and KCBCL, TAIC, CDI, and SAIC were conducted in all participants. Results : Male to female ratio was 0.7:1 in the study group and 1.1:1 in the control group and the mean age was 11.5±2.1 and 12.6±2.0 years old respectively. 73.3% of patients were migraine and 26.7% were tension type headache. The mean of KCBCL total scores was 56.2 in the migraine group, 54.0 in the tension type headache group, and 38.3 in the control group and the score was higher in the headache group(P<0.001). The means of internalizing and externalizing scores were 59.8 and 54.1 in the migraine group, 57.4 and 51.3 in the tension headache group, and 40.1 and 42.4 in the control group respectively and the scores were higher in the headache group(P<0.001). The mean scores of SAIC and TAIC were 36.3 and 33.6 in the migraine group, 36.3 and 34.6 in the tension type headache group, and 25.3 and 26.9 in the control group respectively and the scores were higher in the headache group(P<0.001). The mean scores of CDI were 14.9 in the migraine group, 14.5 in the tension type headache group, and 9.1 in the control group and the scores were higher in the headache group(P=0.002). Conclusion : The patients with recurrent headache showed statistically significant higher scores in CBCL total, internalizing, and externalizing scores, SAIC, TAIC, and CDI in comparison with the control group.