Pediatric neurology · 2026
A Generalist-Deliverable Bio-Psycho-Social Model for Pediatric Chronic Daily Headache: A 24-Month Retrospective Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Go Soken, Morishita Natsumi, Takeshita Mika, Murakami Misako, Minami Saori, Matsumoto Wakako, Hayashi Kanako, Takahashi Ryo, Watanabe Yusuke, Saito Naoko, Ohno Koko, Kasuga Akiko, Morichi Shinichiro, Ishida Yu, Ishii Chiako, Kinjo Naoko, Yamanaka Gaku
Аннотация
BACKGROUND: Chronic daily headache (CDH) in youth is a functionally disabling and diagnostically heterogeneous condition that often requires multifaceted intervention. Real-world care is frequently fragmented-either limited to pharmacologic management or constrained by limited access to behavioral services. We evaluated the effectiveness of a generalist-deliverable bio-psycho-social (BPS) management model for children and adolescents with CDH, addressing both pharmacologic and contextual factors in the absence of subspecialty mental health services.
METHODS: This retrospective, single-center observational study included 37 pediatric patients diagnosed with CDH according to ICHD-3 criteria. All participants received a structured BPS model delivered by general pediatricians. The model comprised (1) feature-guided pharmacologic treatment, (2) narrative-based psychosocial dialog, and (3) gradual school reintegration. Headache frequency, school attendance, and Pediatric Migraine Disability Assessment-assessed disability were evaluated at baseline, 6 months, and 24 months.
RESULTS: By 6 months, only 13.5% of patients met CDH criteria; by 24 months, this decreased to 5.4%. Headache frequency, school attendance, and disability scores improved significantly (P < 0.001 for all). Improvements occurred across diagnostic subtypes and were not solely dependent on pharmacologic treatment, underscoring the contribution of nonpharmacologic components. Functional recovery-particularly school attendance-often lagged behind symptom resolution.
CONCLUSIONS: A generalist-deliverable BPS model was associated with sustained improvement in CDH outcomes, even in the absence of subspecialty resources. This pragmatic framework may support individualized, function-centered care for pediatric CDH in real-world settings.
METHODS: This retrospective, single-center observational study included 37 pediatric patients diagnosed with CDH according to ICHD-3 criteria. All participants received a structured BPS model delivered by general pediatricians. The model comprised (1) feature-guided pharmacologic treatment, (2) narrative-based psychosocial dialog, and (3) gradual school reintegration. Headache frequency, school attendance, and Pediatric Migraine Disability Assessment-assessed disability were evaluated at baseline, 6 months, and 24 months.
RESULTS: By 6 months, only 13.5% of patients met CDH criteria; by 24 months, this decreased to 5.4%. Headache frequency, school attendance, and disability scores improved significantly (P < 0.001 for all). Improvements occurred across diagnostic subtypes and were not solely dependent on pharmacologic treatment, underscoring the contribution of nonpharmacologic components. Functional recovery-particularly school attendance-often lagged behind symptom resolution.
CONCLUSIONS: A generalist-deliverable BPS model was associated with sustained improvement in CDH outcomes, even in the absence of subspecialty resources. This pragmatic framework may support individualized, function-centered care for pediatric CDH in real-world settings.