Systematic Review of Childhood and Adolescent Risk and Prognostic Factors for Recurrent Headaches.
Little is known about childhood and adolescent risk and prognostic factors for recurrent headaches. This systematic review 1) examined longitudinal evidence about factors associated with onset and course of recurrent headaches in childhood or adolescence, using meta-analysis where possible, and 2) evaluated the quality of this evidence using a modified Grading of Recommendations Assessment, Development and Evaluation framework. Through searching electronic databases, reference lists of included studies, and an electronic mail list we identified and included 23 articles reporting 19 cohorts. From the included studies we explored 27 risk factors for recurrent headaches, 27 prognostic factors for persistence of recurrent headaches, and 6 prognostic factors for presence of headache-related disability. The quality of evidence for most associations is low or very low. There is moderate-quality evidence that women are at risk of developing recurrent headaches and of headaches persisting. There is high-quality evidence suggesting that children with negative emotional states manifested through anxiety, depression, or mental distress are not at risk of developing headache, but moderate-quality evidence suggests that the presence of comorbid negative emotional states in children with headaches is associated with increased risk of headache persistence. Because of the small number of studies, further investigation is needed to increase confidence in existing evidence and to explore new risk and prognostic factors.



This is a review of the evidence about childhood and adolescent risk and prognostic factors for the onset of recurrent headaches and their course. Understanding these factors can help identify childrens' risk and may suggest ways to reduce this risk.
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada. Electronic address: anna.huguet@iwk.nshealth.ca.
Anna
A
Huguet
IWK Health Centre, Halifax, Nova Scotia, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.
Michelle E
ME
Tougas
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
Jill
J
Hayden
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada; IWK Health Centre, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Faculty of Science, Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health Authority, Halifax, Nova Scotia, Canada.
Patrick J
PJ
McGrath
IWK Health Centre, Halifax, Nova Scotia, Canada; Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
Christine T
CT
Chambers
Child Health Evaluative Sciences, Chronic Pain Program, The Hospital for Sick Children, Toronto, Ontario, Canada; Chronic Pain Program, The Hospital for Sick Children, Toronto, Ontario, Canada.
Jennifer N
JN
Stinson
IWK Health Centre, Halifax, Nova Scotia, Canada.
Lori
L
Wozney
D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology*; D002648:Child; D003863:Depression / Q000453:epidemiology*; D006261:Headache / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D011379:Prognosis; D012307:Risk Factors
Headache; adolescent; child; prognostic factors; risk factors