{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T19:14:08Z","timestamp":1779390848315,"version":"3.53.1"},"reference-count":45,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuropediatrics"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study aims to evaluate difficulties in emotion regulation and accompanying psychiatric symptoms in adolescents diagnosed with migraine.<\/jats:p><jats:p>The study included 30 adolescents aged 12 to 18 years diagnosed with migraine and 30 age- and sex-matched healthy controls. Participants were assessed using the Difficulties in Emotion Regulation Scale (DERS-16), the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), and the Revised Child Anxiety and Depression Scale (RCADS). Additionally, parents completed the Strengths and Difficulties Questionnaire (SDQ).<\/jats:p><jats:p>Adolescents with migraine showed significantly greater difficulties in emotion regulation (DERS-16 total score, t\u2009=\u20093.521, p\u2009=\u20090.026, effect size\u2009=\u20090.64) and higher levels of depression, generalized anxiety and social anxiety (RCADS score t\u2009=\u20094.328, effect size\u2009=\u20091.32, p\u2009&lt;\u20090.01; t\u2009=\u20092.354, effect size\u2009=\u20090.59, p\u2009=\u20090.022; t\u2009=\u20093.363, effect size\u2009=\u20091.12, p\u2009&lt;\u20090.01, respectively) compared to controls. Parental assessments indicated higher internalizing and total difficulty scores in the migraine group (SDQ score z\u2009=\u20092.633, effect size\u2009=\u2009048, p\u2009=\u20090.008; t\u2009=\u20092.419, effect size\u2009=\u2009032, p\u2009=\u20090.016; t\u2009=\u20092.095, effect size\u2009=\u2009029, p\u2009=\u20090.036, respectively). However, there were no significant group differences in the use of emotion regulation strategies (ERQ-CA score t\u2009=\u2009\u22120.236, p\u2009=\u20090.814; t\u2009=\u2009\u22120.957, p\u2009=\u20090.104, respectively).<\/jats:p><jats:p>This study highlights the psychological and emotional difficulties experienced by adolescents with migraine, emphasizing the importance of early psychiatric evaluation and psychotherapeutic interventions aimed at improving emotion regulation skills and psychosocial interventions focusing on lifestyle modifications as part of comprehensive migraine management. Limitations include the cross-sectional design, reliance on self-report measures, and modest sample size, which may limit generalizability. Future longitudinal and neurobiologically informed research is needed to clarify causal relationships and intervention targets.<\/jats:p>","DOI":"10.1055\/a-2595-0501","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T18:53:45Z","timestamp":1745866425000},"page":"328-337","source":"Crossref","is-referenced-by-count":3,"title":["Difficulties in Emotion Regulation and Psychiatric Symptoms in Adolescents Diagnosed with Migraine: A Case-Control Study"],"prefix":"10.1055","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7195-2293","authenticated-orcid":false,"given":"G\u00fcls\u00fcm Yitik","family":"Tonkaz","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry Department, Giresun University, Faculty of Medicine, Giresun, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0731-0231","authenticated-orcid":false,"given":"\u015eeyda","family":"Arslan","sequence":"additional","affiliation":[{"name":"Family Medicine Clinic, Bulancak State Hospital, Giresun, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5759-0206","authenticated-orcid":false,"given":"G\u00f6khan","family":"Tonkaz","sequence":"additional","affiliation":[{"name":"Radiology Department, Giresun University, Faculty of Medicine, Giresun, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9467-3641","authenticated-orcid":false,"given":"Ali","family":"\u00c7akir","sequence":"additional","affiliation":[{"name":"Child and Adolescent Psychiatry Clinic, Erzurum Regional Training and Research Hospital, Erzurum, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3236-4285","authenticated-orcid":false,"given":"Serdar","family":"Sarita\u015f","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Clinic, Bursa Dortcelik Pediatric Disease Hospital, Bursa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0905-9592","authenticated-orcid":false,"given":"Aysun Hacer","family":"Sarita\u015f","sequence":"additional","affiliation":[{"name":"Pediatri Clinic, Bursa Jimer Hospital, Bursa, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2025,5,8]]},"reference":[{"issue":"12","key":"ref1","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/j.1469-8749.2010.03793.x","article-title":"Prevalence of headache and migraine in children and adolescents: a systematic review of population-based studies","volume":"52","author":"I Abu-Arafeh","year":"2010","journal-title":"Dev Med Child Neurol"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/dmcn.14338","article-title":"Episodic and chronic migraine in children","volume":"62","author":"P E Youssef","year":"2020","journal-title":"Dev Med Child Neurol"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1177\/0883073814549240","article-title":"The prevalence of migraine and tension-type headache among schoolchildren in Kayseri, Turkey: an evaluation of sensitivity and specificity using multivariate analysis","volume":"30","author":"H G Poyrazo\u011flu","year":"2015","journal-title":"J Child Neurol"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1016\/S1474-4422(18)30085-1","article-title":"International classification of headache disorders","volume":"17","author":"J Olesen","year":"2018","journal-title":"Lancet Neurol"},{"key":"ref5","volume-title":"The development of emotion regulation: Implications for child adjustment","author":"S D Calkins"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.chc.2021.04.001","article-title":"Development of emotion regulation in typically developing children","volume":"30","author":"J A Crowell","year":"2021","journal-title":"Child Adolesc Psychiatr Clin N Am"},{"issue":"11","key":"ref7","first-page":"1630","article-title":"Emotional experience and regulation in juvenile primary headaches: a cross-sectional pilot study","volume":"9","author":"M Miscioscia","year":"2022","journal-title":"Children (Basel)"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1090878","DOI":"10.3389\/fneur.2023.1090878","article-title":"Associations between anxiety, depression with migraine, and migraine-related burdens","volume":"14","author":"S Duan","year":"2023","journal-title":"Front Neurol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"560138","DOI":"10.3389\/fpsyt.2020.560138","article-title":"Comorbid bipolar disorder and migraine: from mechanisms to treatment","volume":"11","author":"J Duan","year":"2021","journal-title":"Front Psychiatry"},{"issue":"07","key":"ref10","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1136\/jnnp-2015-312233","article-title":"Migraine and its psychiatric comorbidities","volume":"87","author":"M T Minen","year":"2016","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"02","key":"ref11","doi-asserted-by":"crossref","first-page":"463","DOI":"10.3390\/biomedicines13020463","article-title":"Chronic stress and headaches: the role of the HPA axis and autonomic nervous system","volume":"13","author":"A Sic","year":"2025","journal-title":"Biomedicines"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s10194-021-01271-1","article-title":"Migraine and neuroinflammation: the inflammasome perspective","volume":"22","author":"O Kursun","year":"2021","journal-title":"J Headache Pain"},{"issue":"07","key":"ref13","doi-asserted-by":"crossref","first-page":"3654","DOI":"10.1007\/s00415-023-11706-1","article-title":"Migraine: from pathophysiology to treatment","volume":"270","author":"F Puledda","year":"2023","journal-title":"J Neurol"},{"issue":"13","key":"ref14","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1177\/03331024211021792","article-title":"Migraine and the development of additional psychiatric and pain disorders in the transition from adolescence to adulthood","volume":"41","author":"L Gerstl","year":"2021","journal-title":"Cephalalgia"},{"issue":"S 01","key":"ref15","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1007\/s10072-015-2135-z","article-title":"Adolescent migraine: diagnostic and therapeutic approaches","volume":"36","author":"R Sangermani","year":"2015","journal-title":"Neurol Sci"},{"issue":"03","key":"ref16","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1212\/CON.0000000000000993","article-title":"Headache in children and adolescents","volume":"27","author":"C Szperka","year":"2021","journal-title":"Continuum (Minneap Minn)"},{"issue":"05","key":"ref17","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/j.1469-7610.1997.tb01545.x","article-title":"The strengths and difficulties questionnaire: a research note","volume":"38","author":"R Goodman","year":"1997","journal-title":"J Child Psychol Psychiatry"},{"issue":"02","key":"ref18","first-page":"65","article-title":"G\u00fc\u00e7ler ve g\u00fc\u00e7l\u00fckler anketi'nin (gga) T\u00fcrk\u00e7e uyarlamasinin psikometrik \u00f6zellikleri","volume":"15","author":"T G\u00fcvenir","year":"2008","journal-title":"Turkish Journal of Child and Adolescent Mental Health"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1080\/24750573.2017.1297494","article-title":"Psychometric properties of the Turkish version of the Revised Child Anxiety and Depression Scale\u2013Child Version in a clinical sample","volume":"27","author":"V Gormez","year":"2017","journal-title":"Psychiatry Clin Psychopharmacol"},{"issue":"02","key":"ref20","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s10862-015-9514-x","article-title":"Development and validation of a brief version of the difficulties in emotion regulation scale: the DERS-16","volume":"38","author":"J Bjureberg","year":"2016","journal-title":"J Psychopathol Behav Assess"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.1007\/s12144-017-9712-7","article-title":"Psychometric properties of Turkish version of difficulties in emotion regulation scale-brief form (DERS-16)","volume":"38","author":"\u0130 Yi\u011fit","year":"2019","journal-title":"Curr Psychol"},{"issue":"02","key":"ref22","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1037\/a0025777","article-title":"The emotion regulation questionnaire for children and adolescents (ERQ\u2013CA): a psychometric evaluation","volume":"24","author":"E Gullone","year":"2012","journal-title":"Psychol Assess"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"87","DOI":"10.35379\/cusosbil.942135","article-title":"\u00c7ocuk Ve Ergenlerde Duygu D\u00fczenleme \u00d6l\u00e7e\u011finin T\u00fcrk\u00e7eye Uyarlanmasi","volume":"30","author":"S Tetik","year":"2021","journal-title":"\u00c7ukurova \u00dcniversitesi Sosyal Bilimler Enstit\u00fcs\u00fc Dergisi"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"109960","DOI":"10.1016\/j.jpsychores.2020.109960","article-title":"Exploring emotional dysregulation characteristics and comorbid psychiatric disorders in type 1 diabetic children with disordered eating behavior risk","volume":"131","author":"H Yilmaz Kafali","year":"2020","journal-title":"J Psychosom Res"},{"issue":"S 02","key":"ref25","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/j.1526-4610.2012.02241.x","article-title":"Migraine: maladaptive brain responses to stress","volume":"52","author":"N Maleki","year":"2012","journal-title":"Headache"},{"issue":"02","key":"ref26","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.neuron.2012.01.001","article-title":"Understanding migraine through the lens of maladaptive stress responses: a model disease of allostatic load","volume":"73","author":"D Borsook","year":"2012","journal-title":"Neuron"},{"issue":"04","key":"ref27","doi-asserted-by":"crossref","first-page":"52","DOI":"10.3390\/bs11040052","article-title":"Migraine and mood in children","volume":"11","author":"P Gazerani","year":"2021","journal-title":"Behav Sci (Basel)"},{"issue":"09","key":"ref28","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1111\/j.1526-4610.2006.00583.x","article-title":"Headache and psychological functioning in children and adolescents","volume":"46","author":"S W Powers","year":"2006","journal-title":"Headache"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"199","DOI":"10.3389\/fneur.2019.00199","article-title":"Pediatric vs. adult prodrome and postdrome: a window on migraine pathophysiology?","volume":"10","author":"J-C Cuvellier","year":"2019","journal-title":"Front Neurol"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/1129-2377-16-10","article-title":"The relationship of anxiety, depression and behavioral problems with recurrent headache in late adolescence \u2013 a young-HUNT follow-up study","volume":"16","author":"B A Blaauw","year":"2015","journal-title":"J Headache Pain"},{"issue":"01","key":"ref31","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1017\/cjn.2016.402","article-title":"Migraine and mental health in a population-based sample of adolescents","volume":"44","author":"S L Orr","year":"2017","journal-title":"Can J Neurol Sci"},{"issue":"02","key":"ref32","first-page":"161","article-title":"Migren ve gerilim tipi ba\u015f a\u011fr\u0131s\u0131 olan ergenlerde anksiyete duyarl\u0131l\u0131\u011f\u0131 ve dissosiyatif belirtiler","volume":"14","author":"\u00d6F Ak\u00e7a","year":"2013","journal-title":"Anatol J Psych"},{"issue":"06","key":"ref33","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1111\/j.1526-4610.2004.446004.x","article-title":"The medical costs of migraine and comorbid anxiety and depression","volume":"44","author":"J Pesa","year":"2004","journal-title":"Headache"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.ejpn.2022.01.011","article-title":"Migraine and epilepsy: social cognition skills in pediatric population","volume":"37","author":"F F Operto","year":"2022","journal-title":"Eur J Paediatr Neurol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"774","DOI":"10.3389\/fneur.2019.00774","article-title":"Alexithymia, metacognition, and theory of mind in children and preadolescents with migraine without aura (MWoA): a case-control study","volume":"10","author":"G Natalucci","year":"2019","journal-title":"Front Neurol"},{"issue":"17","key":"ref36","doi-asserted-by":"crossref","first-page":"5090","DOI":"10.3390\/jcm11175090","article-title":"Psychiatric comorbidity and emotional dysregulation in chronic tension-type headache: a case-control study","volume":"11","author":"R Romero-Godoy","year":"2022","journal-title":"J Clin Med"},{"issue":"04","key":"ref37","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1177\/0333102419885394","article-title":"The relation between emotion regulation and migraine: a cross-cultural study on the moderating effect of culture","volume":"40","author":"J Wolf","year":"2020","journal-title":"Cephalalgia"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"650","DOI":"10.3389\/fneur.2017.00650","article-title":"Metacognition and headache: which is the role in childhood and adolescence?","volume":"8","author":"N Faedda","year":"2017","journal-title":"Front Neurol"},{"issue":"S 01","key":"ref39","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1007\/s10072-019-03805-7","article-title":"Metacognition and theory of mind in children with migraine and children with internalizing disorders","volume":"40","author":"G Natalucci","year":"2019","journal-title":"Neurol Sci"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.jpsychires.2021.04.021","article-title":"Clinical risk factors, emotional reactivity\/regulation and suicidal ideation in elementary school-aged children","volume":"138","author":"A H Sheftall","year":"2021","journal-title":"J Psychiatr Res"},{"issue":"01","key":"ref41","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/bjdp.12525","article-title":"Parental control and adolescent social anxiety: A focus on emotional regulation strategies and socioeconomic influences in China","volume":"43","author":"W Fu","year":"2025","journal-title":"Br J Dev Psychol"},{"key":"ref42","first-page":"43","article-title":"[Brain network dysfunctions as substrates of primary headaches]","volume":"213","author":"L Bourgeais-Rambur","year":"2019","journal-title":"Biol Aujourdhui"},{"issue":"08","key":"ref43","doi-asserted-by":"crossref","first-page":"e103929","DOI":"10.1371\/journal.pone.0103929","article-title":"Neurochemical pathways that converge on thalamic trigeminovascular neurons: potential substrate for modulation of migraine by sleep, food intake, stress and anxiety","volume":"9","author":"R Noseda","year":"2014","journal-title":"PLoS One"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"631","DOI":"10.2147\/JPR.S296540","article-title":"Dopaminergic regulation of reward system connectivity underpins pain and emotional suffering in migraine","volume":"14","author":"D J Kim","year":"2021","journal-title":"J Pain Res"},{"issue":"06","key":"ref45","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1111\/head.13814","article-title":"Alterations in brain function after cognitive behavioral therapy for migraine in children and adolescents","volume":"60","author":"H Nahman-Averbuch","year":"2020","journal-title":"Headache"}],"container-title":["Neuropediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2595-0501.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T22:42:06Z","timestamp":1757457726000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2595-0501"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":45,"journal-issue":{"issue":"05","published-online":{"date-parts":[[2025,9,9]]},"published-print":{"date-parts":[[2025,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2595-0501","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0174-304X","1439-1899"],"issn-type":[{"value":"0174-304X","type":"print"},{"value":"1439-1899","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4,28]]},"published":{"date-parts":[[2025,4,28]]}}}