Anxiety, depression, fatigue, and headache burden in the pediatric hydrocephalus population

View More View Less
  • 1 Department of Neurosurgery, Division of Pediatrics; Departments of
  • 3 Psychology and
  • 4 Statistics, University of Alabama at Birmingham, Alabama; and
  • 2 School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi
Restricted access

Purchase Now

USD  $45.00

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00
Print or Print + Online

OBJECTIVE

Childhood hydrocephalus is a common chronic medical condition. However, little is known about the burden of headache and psychological comorbidities in children living with hydrocephalus. The purpose of this study was to determine the prevalence and severity of these conditions among the pediatric hydrocephalus population.

METHODS

During routine neurosurgery clinic visits from July 2017 to February 2018, the authors administered four surveys to children ages 7 years and older: Pediatric Migraine Disability Assessment (PedMIDAS), Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, PROMIS Depression, and PROMIS Fatigue. The PedMIDAS is an assessment of headache disability in pediatric and adolescent patients. The PROMIS measures are pediatric self-reported instruments to assess social and emotional health. PROMIS measures utilize T-scores (mean 50, SD 10) to compare anxiety, depression, and fatigue in specific populations to those in the US general population. Clinical and demographic data were collected from the medical record (hydrocephalus etiology, shunt infection, race, etc.) and tested for associations with survey measure scores.

RESULTS

Forty children completed the PedMIDAS. Ten percent of them were in the severe headache range, 5% were in the moderate range, and 5% were in the mild range. There was a statistically significant association between undergoing a cluster of shunt operations and headache burden (p = 0.003).

Forty children completed all three PROMIS measures. The mean anxiety score was 45.8 (SD 11.7), and 2.5% of children scored in the severe anxiety range, 17.5% in the moderate range, and 20% in the mild range. The mean depression score was 42.7 (SD 10.0), with 2.5% of children scoring in the severe depression range, 5% in the moderate range, and 12.5% in the mild range. The mean fatigue score was 45.1 (SD 16.4), with 15% percent of children scoring in the severe fatigue range, 10% in the moderate range, and 7.5% in the mild range. There were no statistically significant associations between child anxiety, depression, or fatigue and clinical or demographic variables.

CONCLUSIONS

Children with hydrocephalus have an average burden of headache, anxiety, depression, and fatigue as compared to the general population overall. Having a cluster of shunt operations correlates with a higher headache burden, but no clinical or demographic variable is associated with anxiety, depression, or fatigue.

ABBREVIATIONS ETV = endoscopic third ventriculostomy; PedMIDAS = Pediatric Migraine Disability Assessment; PROMIS = Patient-Reported Outcomes Measurement Information System.

JNS + Pediatrics - 1 year subscription bundle (Individuals Only)

USD  $505.00

JNS + Pediatrics + Spine - 1 year subscription bundle (Individuals Only)

USD  $600.00

Contributor Notes

Correspondence Brandon G. Rocque: University of Alabama at Birmingham, AL. brandon.rocque@childrensal.org.

INCLUDE WHEN CITING Published online July 24, 2020; DOI: 10.3171/2020.4.PEDS19697.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

  • 1

    Simon TD, Riva-Cambrin J, Srivastava R, Hospital care for children with hydrocephalus in the United States: utilization, charges, comorbidities, and deaths. J Neurosurg Pediatr. 2008;1(2):131137.

    • Search Google Scholar
    • Export Citation
  • 2

    Kahle KT, Kulkarni AV, Limbrick DD Jr, Warf BC. Hydrocephalus in children. Lancet. 2016;387(10020):788799.

  • 3

    Burke P, Meyer V, Kocoshis S, Depression and anxiety in pediatric inflammatory bowel disease and cystic fibrosis. J Am Acad Child Adolesc Psychiatry. 1989;28(6):948951.

    • Search Google Scholar
    • Export Citation
  • 4

    Cruz I, Marciel KK, Quittner AL, Schechter MS. Anxiety and depression in cystic fibrosis. Semin Respir Crit Care Med. 2009;30(5):569578.

    • Search Google Scholar
    • Export Citation
  • 5

    Dantzer C, Swendsen J, Maurice-Tison S, Salamon R. Anxiety and depression in juvenile diabetes: a critical review. Clin Psychol Rev. 2003;23(6):787800.

    • Search Google Scholar
    • Export Citation
  • 6

    Kellerman J, Zeltzer L, Ellenberg L, Psychological effects of illness in adolescence. I. Anxiety, self-esteem, and perception of control. J Pediatr. 1980;97(1):126131.

    • Search Google Scholar
    • Export Citation
  • 7

    Knight A, Weiss P, Morales K, Identifying differences in risk factors for depression and anxiety in pediatric chronic disease: a matched cross-sectional study of youth with lupus/mixed connective tissue disease and their peers with diabetes. J Pediatr. 2015;167(6):13971403.e1.

    • Search Google Scholar
    • Export Citation
  • 8

    Kumar S, Powars D, Allen J, Haywood LJ. Anxiety, self-concept, and personal and social adjustments in children with sickle cell anemia. J Pediatr. 1976;88(5):859863.

    • Search Google Scholar
    • Export Citation
  • 9

    Mackner LM, Crandall WV, Szigethy EM. Psychosocial functioning in pediatric inflammatory bowel disease. Inflamm Bowel Dis. 2006;12(3):239244.

    • Search Google Scholar
    • Export Citation
  • 10

    Moreira JM, Bouissou Morais Soares CM, Teixeira AL, Anxiety, depression, resilience and quality of life in children and adolescents with pre-dialysis chronic kidney disease. Pediatr Nephrol. 2015;30(12):21532162.

    • Search Google Scholar
    • Export Citation
  • 11

    Oguz A, Kurul S, Dirik E. Relationship of epilepsy-related factors to anxiety and depression scores in epileptic children. J Child Neurol. 2002;17(1):3740.

    • Search Google Scholar
    • Export Citation
  • 12

    Vila G, Nollet-Clemençon C, de Blic J, Prevalence of DSM IV anxiety and affective disorders in a pediatric population of asthmatic children and adolescents. J Affect Disord. 2000;58(3):223231.

    • Search Google Scholar
    • Export Citation
  • 13

    Tomé-Pires C, Solé E, Racine M, The relative importance of anxiety and depression in pain impact in individuals with migraine headaches. Scand J Pain. 2016;13:109113.

    • Search Google Scholar
    • Export Citation
  • 14

    Harris PA, Taylor R, Thielke R, Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42(2):377381.

    • Search Google Scholar
    • Export Citation
  • 15

    Hershey AD, Powers SW, Vockell AL, PedMIDAS: development of a questionnaire to assess disability of migraines in children. Neurology. 2001;57(11):20342039.

    • Search Google Scholar
    • Export Citation
  • 16

    Stewart WF, Lipton RB, Dowson AJ, Sawyer J. Development and testing of the Migraine Disability Assessment (MIDAS) Questionnaire to assess headache-related disability. Neurology. 2001;56(6)(suppl 1):S20S28.

    • Search Google Scholar
    • Export Citation
  • 17

    Hinds PS, Nuss SL, Ruccione KS, PROMIS pediatric measures in pediatric oncology: valid and clinically feasible indicators of patient-reported outcomes. Pediatr Blood Cancer. 2013;60(3):402408.

    • Search Google Scholar
    • Export Citation
  • 18

    Beez T, Bellstädt L, Steiger H-J, Sarikaya-Seiwert S. Headache and shunt-related impact on activities of daily life in patients growing up with a ventriculoperitoneal shunt. J Neurol Surg A Cent Eur Neurosurg. 2018;79(3):196199.

    • Search Google Scholar
    • Export Citation
  • 19

    Albers L, Straube A, Landgraf MN, Migraine and tension type headache in adolescents at grammar school in Germany—burden of disease and health care utilization. J Headache Pain. 2015;16:534.

    • Search Google Scholar
    • Export Citation
  • 20

    Bektaş Ö, Uğur C, Gençtürk ZB, Relationship of childhood headaches with preferences in leisure time activities, depression, anxiety and eating habits: a population-based, cross-sectional study. Cephalalgia. 2015;35(6):527537.

    • Search Google Scholar
    • Export Citation
  • 21

    Torres-Ferrus M, Vila-Sala C, Quintana M, Headache, comorbidities and lifestyle in an adolescent population (The TEENs Study). Cephalalgia. 2019;39(1):9199.

    • Search Google Scholar
    • Export Citation
  • 22

    DeWalt DA, Gross HE, Gipson DS, PROMIS® pediatric self-report scales distinguish subgroups of children within and across six common pediatric chronic health conditions. Qual Life Res. 2015;24(9):21952208.

    • Search Google Scholar
    • Export Citation

Metrics

All Time Past Year Past 30 Days
Abstract Views 89 89 68
Full Text Views 28 28 25
PDF Downloads 26 26 25
EPUB Downloads 0 0 0