Prevalence and predictors of headaches in US adolescents.
OBJECTIVE
To examine the prevalence of headaches among US adolescents; to explore the differences in prevalence by sex, race, and age; and to test the nature of the association between headaches and depression, self-esteem, and insomnia.


METHODS
This longitudinal study used a nationally representative sample of adolescents (n = 6072) who were interviewed in 1995 (wave 1) and then interviewed a year later in 1996 (wave 2). Path analyses were used to test for the relationships among headaches, insomnia, depression, and self-esteem.


RESULTS
More than 90% of subjects had experienced one or more headaches during the past 12 months. Of that 90%, about 30% reported recurrent headaches occurring weekly or more frequently. Girls tended to report more recurrent headaches (37.6%) than boys (21.3%). American Indians experienced the highest rate (35. 6%) of recurrent headaches followed by white adolescents (32.1%). Depression and low self-esteem in wave 1 were found to precede the headaches in wave 2 in girls, but not in boys. No causal relationship was found between insomnia and headaches.


CONCLUSIONS
Headaches are prevalent among US adolescents, especially in girls and American Indians. This study suggests the existence of different paths involving different factors in headache-presenting behavior for boys and girls. Further studies are needed to illustrate the different mechanisms of headache in the two sexes.
School of Nursing, Department of Children's Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
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D000293:Adolescent; D003863:Depression / Q000150:complications; D005260:Female; D005544:Forecasting; D006261:Headache / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012008:Recurrence; D012649:Self Concept; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications; D014481:United States / Q000453:epidemiology