Multiple perspectives on the psychological functioning of children with and without migraine.

OBJECTIVE: To use a case-control design to evaluate the emotional and behavioral functioning of children with migraine. BACKGROUND: Research has indicated that children with migraine are at increased risk for emotional and behavioral problems such as depression and anxiety; however, methodological limitations in sample definitions, measurement strategies, and comparison groups remain problematic. METHOD: Forty-seven participants diagnosed with migraine at a pediatric headache center participated in a home-based study of child functioning using standardized measures. Mothers and fathers of these children participated, as did control families recruited from among classmates. RESULTS: Indications of increased emotional and behavioral difficulties for children with migraine were found, primarily from the perspective of mothers. Exploratory analyses found several associations between mother and child perceptions of difficulties and persistence of headache symptoms following initiation of multidisciplinary headache treatment. CONCLUSIONS: Continued concern regarding emotional well-being of children with migraine is warranted, but more work is needed to understand the differing perspectives of family members. Particular attention to emotional well-being is needed for children whose headache symptoms persist despite multidisciplinary treatment.

Pediatric Weight Management Program Outcomes in a Largely Minority, Low Socioeconomic Status Population.

This article describes the outcomes of a pediatric weight management program for a population primarily composed of minority ethnic groups and those from a lower socioeconomic status group. As these groups are disproportionally affected by pediatric obesity and overweight complicated by higher rates of attrition and poorer response to intervention, it is important that adequate and effective treatment exists for patients in these groups. Further research is needed to analyze the outcomes and attrition in these high-risk populations.

Developing criteria for pediatric/adolescent bariatric surgery programs.

The prevalence of morbid obesity in adolescents is rising at an alarming rate. Comorbidities known to predispose to cardiovascular disease are increasingly being diagnosed in these children. Bariatric surgery has become an acceptable treatment alternative for morbidly obese adults, and criteria have been developed to establish center-of-excellence designation for adult bariatric surgery programs. Evidence suggests that bariatric surgical procedures are being performed with increasing numbers in adolescents. We have examined and compiled the current expert recommendations for guidelines and criteria that are needed to deliver safe and effective bariatric surgical care to adolescents.