Headache disability among adolescents: a student population-based study.
OBJECTIVE
To examine the extent and to identify the relevant predictors of headache disabilities in adolescents.


BACKGROUND
Headaches are common in adolescents but their impact and related factors have not been extensively studied in adolescent communities.


METHODS
We recruited and surveyed 3963 students aged 13-15 from 3 middle schools using self-administered questionnaires. The questionnaires were used to make 3 assessments: (1) headaches were diagnosed using a validated headache questionnaire; (2) headache disabilities were evaluated using the 6-question Pediatric Migraine Disability Assessment; (3) depression was measured using the Adolescent Depression Inventory.


RESULTS
The student response rate was 93%. In total, 484 students (12.2%) had migraines with or without auras, 444 (11.2%) had probable migraines, and 1092 (27.6%) had tension-type headaches. The students with migraine had the highest Pediatric Migraine Disability Assessment scores (10.7 +/- 20.0); whereas, the students with tension-type headaches had the lowest scores (2.0 +/- 4.4). Logistic regression analyses indicated that there were a number of independent predictors for moderate to severe headache-related disability (Pediatric Migraine Disability Assessment score > or =31), including a migraine or probable migraine diagnosis, a higher depression score, severe headache intensity, and frequent headaches.


CONCLUSIONS
The Pediatric Migraine Disability Assessment provides a simple tool to measure the impact of headaches in adolescents. Adolescents with migraine headaches suffered the greatest level of disability. Higher depression scores were associated with more severe headache-related disabilities in adolescents, independent of headache frequency and severity.
Fuh
Jong-Ling
JL
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Wang
Shuu-Jiun
SJ
Lu
Shiang-Ru
SR
Liao
Yi-Chu
YC
Chen
Shih-Pin
SP
Yang
Chin-Yi
CY
D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D015984:Causality; D015331:Cohort Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D020773:Headache Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D006306:Health Surveys; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D009483:Neuropsychological Tests; D010147:Pain Measurement / Q000379:methods; D011237:Predictive Value of Tests; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D018781:Tension-Type Headache / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology