title: Headache in school children: prevalence and risk factors.
abstract: BACKGROUND
  Recurrent headache is a common problem in school children. Evaluation generally leads to the diagnosis of a primary headache syndrome (migraine or tension-type headache). This review is addressed to the question whether headaches in school children are becoming more common and, if so, what risk factors are associated with the rise in frequency.
  
  
  METHODS
  We selectively searched the PubMed database for pertinent publications that contained the terms "primary headache AND children/adolescent AND risk factors/prevalence." Articles published in either English or German up to April 2013 were considered. Articles on secondary types of headache were excluded.
  
  
  RESULTS
  Headaches are becoming more common among school children. At present, 66% to 71% of 12- to 15- year-olds have at least one headache every three months, and 33% to 40% have at least one per week. Headache is often accompanied by other physical and/or emotional manifestations. Studies from Scandinavia reveal increasing prevalence in age groups from 8 years of age and upward. Various studies have identified the following risk factors for headache or for its chronification (up to 5.8-fold elevation of risk): a dysfunctional family situation, the regular consumption of alcohol, caffeine ingestion, smoking, a low level of physical activity, physical or emotional abuse, bullying by peers, unfair treatment in school, and insufficient leisure time.
  
  
  CONCLUSIONS
  Headaches are becoming more common among children and adolescents. They are often associated with other physical and emotional complaints.
authors: Department of Neurology, University of Munich, Campus Grosshadern, Department of Pediatric Neurology, University of Munich, Campus Innenstadt, Dr. von Haunersches Kinderspital, Clinic for Child and Adolescent Medicine, St. Vincent Hospital, Paderborn, and Center for Child and Adolescent Medicine, University of Heidelberg, Institute of Social Paediatrics and Adolescent Medicine, University of Munich.
authors: Andreas
authors: A
authors: Straube
authors: Florian
authors: F
authors: Heinen
authors: Friedrich
authors: F
authors: Ebinger
authors: Rüdiger
authors: R
authors: von Kries
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000428:Alcohol Drinking / Q000453:epidemiology*; D058445:Bullying; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D051270:Headache Disorders, Primary / Q000453:epidemiology*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology*; D013315:Stress, Psychological / Q000453:epidemiology*; D013334:Students / Q000706:statistics & numerical data*; D055815:Young Adult