Objective.- To determine whether behavioral and psychiatric disorders occur more frequently in school- age children with migraine headache. To also elucida te treatment response related to comorbid psychiatric or behavioral diagnosis. B ackground.- Recurrent migraine headaches are common in school- age children. C oncurrent behavioral or psychiatric diagnoses could significantly impact headach e frequency, severity, and response to treatment. Methods.- Healthy children fr om 6 to 17 years of age presenting to our headache clinic with migraine headache according to International Headache Society (IHS) criteria were identified. Par ents/guardians were asked to complete the Child Symptom Inventory, 4th edition ( CSI- 4) after written informed consent. Children with positive rating scales un derwent psychological interviews for confirmatory diagnosis. Results were compar ed to controls. Headache patients were assigned our usual treatment paradigm. Response regarding heada che frequency was assessed at 3 months. Results.- A total of 47 patients were d iagnosed with migraine headaches. The mean age was 10.55 years. Thirty controls were identified. After completing the CSI- 4 and confirmatory psychological int erview, 14 of 47 headache patients fulfilled Diagnostic and Statistical Manual ( DSM- 4) criteria for a psychiatric or behavioral disorder. Oppositional defiant disorder (ODD) was significantly represented among children with migraine compa red to the control group of children. Headache patients improved significantly p ost- treatment regarding their headache frequencies regardless of comorbid psyc hiatric or behavioral disorder. No significant differences were noted between bo ys and girls regarding diagnoses or treatment outcome. Conclusion.- ODD was a s ignificant comorbidity in our headache population. Although families complained of significant behavioral symptomatology in their children, most of these sympto ms did not qualify their children for a psychiatric diagnosis and may be related to the stressors of headache on social/school disruption. Objectives- To determine whether behavioral and psychiatric disorders occur more frequently in school-age children with migraine headache. To also elucidation of treatment related to comorbid psychiatric or behavioral diagnosis. B ackground .- Recurrent migraine headaches are common in school-age children Method C-current behavioral or psychiatric diagnoses could significantly impact headach e frequency, severity, and response to treatment. Methods.- Healthy children fr om 6 to 17 years of age presenting to our headache clinic with migraine headache according to International Headache Society (IHS) Criteria were identified. Par ents / guardians were asked to complete the Child Symptom Inventory, 4th edition (CSI- 4) after written informed consent. Children with positive rating scales un derwent psychological interviews for confirmatory diagnosis. Results were compar ed to controls. Headache patients were assigned our usual treatment paradigm. Response regarding heada che frequency was The mean age was 10.55 years. Thirty controls were identified. After completing the CSI-4 and confirmatory psychological int erview, 14 of 47 headache patients fulfilled Diagnostic and Statistical Manual (DSM-4) criteria for a psychiatric or behavioral disorder. Oppositional defiant disorder (ODD) was significantly represented among children with migraine compa red to the control group of children. Headache patients improved significantly p ost- treatment regarding their headache No significant differences were noted between bo ys and girls regarding diagnoses or treatment outcome. Conclusion .- ODD was as ignificant comorbidity in our headache population. Although families complained of significant behavioral symptomatology in their children, most of these sympto ms did not qualify their children for a psychiatric ddiagnosis and may be related to the stressors of headache on social / school disruption