A child with headache and anxiety disorder including school refusal

Abstract

A 10-year-old girl presents with a daily headache for the past 2 months. She suffered from headache since 4-5 years of age with infrequent attacks. During the past month, her school attendance was interrupted due to symptoms of separation anxiety (nightmares, refusal to see peers and go to school, and cardiovascular symptoms). Her mother administered analgesics on rare occasions. On the basis of the clinical history, she was thought to have a probable chronic tension-type headache, and a psychological assessment was deemed necessary, which confirmed the separation anxiety disorder as the cause of her symptoms. The patient and the family have been invited to join a family psychotherapy program. After a few months, headache returned to an episodic pattern, the child returned to school, and the family reached a new “healthier” equilibrium.