Download PDF
Neuropediatrics 2013; 44(01): 046-054
DOI: 10.1055/s-0032-1333432
Review Article
Georg Thieme Verlag KG Stuttgart · New York

How Specific Are Risk Factors for Headache in Adolescents? Results from a Cross-sectional Study in Germany

Steffi Lehmann
1   Institute of Social Paediatrics and Adolescent Medicine, Medical Faculty of the Ludwig-Maximilians-University Munich, Munich, Bavaria, Germany
,
Astrid Milde-Busch
1   Institute of Social Paediatrics and Adolescent Medicine, Medical Faculty of the Ludwig-Maximilians-University Munich, Munich, Bavaria, Germany
,
Andreas Straube
2   Department of Neurology, University of Munich, Munich, Germany
,
Ruediger von Kries
1   Institute of Social Paediatrics and Adolescent Medicine, Medical Faculty of the Ludwig-Maximilians-University Munich, Munich, Bavaria, Germany
,
Florian Heinen
3   Department of Paediatric Neurology and Developmental Medicine, Hauner Children's Hospital, University of Munich, Munich, Germany
› Author Affiliations
Further Information

Publication History

14 September 2012

12 December 2012

Publication Date:
10 January 2013 (online)

   Permissions and Reprints

Abstract

Background The identified preventable risk factors for primary headache in adolescents are smoking; consumption of coffee or alcoholic mixed drinks; physical inactivity; muscle pain in the head, neck, or shoulder region; and chronic stress.

Objective To investigate the interrelation of headache with other health complaints and the specificity of the above-mentioned risk factors for headache in adolescents.

Methods A total of 1,260 students (grades 10 and 11) filled in questionnaires on headache, dietary, and lifestyle factors. The type of headache and health complaints such as dizziness, abdominal pain, musculoskeletal pains, symptoms of possible fatigue syndrome, and psychic complaints were assessed.

Results Isolated headache was found in 18% of the headache sufferers; most frequently isolated tension-type headache (78.2%). Only among adolescents with a combination of headache (mainly migraine) and other health complaints, significant associations for almost all analyzed risk factors were found. The strength of the associations with the considered risk factors was very similar in all three analyzed strata except for considerably lower odds ratios for isolated headache.

Conclusion All analyzed risk factors are nonspecific for headache in adolescents because they also increase the risk for other health complaints. Interventions, therefore, should consider a holistic approach focusing not only on headache but also on a broader spectrum of health complaints.

Keywords

isolated headache - adolescents - pain - health complaints - risk factors - specificity
 

  • References

  • 1 Rasmussen BK. Epidemiology of headache. Cephalalgia 2001; 21 (7) 774-777
    CrossrefPubMedGoogle Scholar
  • 2 Roth-Isigkeit A, Thyen U, Raspe HH, Stöven H, Schmucker P. Reports of pain among German children and adolescents: an epidemiological study. Acta Paediatr 2004; 93 (2) 258-263
    CrossrefPubMedGoogle Scholar
  • 3 Fendrich K, Vennemann M, Pfaffenrath V , et al. Headache prevalence among adolescents—the German DMKG headache study. Cephalalgia 2007; 27 (4) 347-354
    CrossrefPubMedGoogle Scholar
  • 4 Kröner-Herwig B, Heinrich M, Morris L. Headache in German children and adolescents: a population-based epidemiological study. Cephalalgia 2007; 27 (6) 519-527
    CrossrefPubMedGoogle Scholar
  • 5 Heinrich M, Morris L, Kröner-Herwig B. Self-report of headache in children and adolescents in Germany: possibilities and confines of questionnaire data for headache classification. Cephalalgia 2009; 29 (8) 864-872
    CrossrefPubMedGoogle Scholar
  • 6 Milde-Busch A, Blaschek A, Borggräfe I, von Kries R, Straube A, Heinen F. [Is there an association between the reduced school years in grammar schools and headache and other health complaints in adolescent students?]. Klin Padiatr 2010; 222 (4) 255-260
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Milde-Busch A, Heinrich S, Thomas S , et al. Quality of life in adolescents with headache: results from a population-based survey. Cephalalgia 2010; 30 (6) 713-721
    CrossrefPubMedGoogle Scholar
  • 8 Stovner LJ, Andree C. Prevalence of headache in Europe: a review for the Eurolight project. J Headache Pain 2010; 11 (4) 289-299
    CrossrefPubMedGoogle Scholar
  • 9 Ozge A, Sasmaz T, Cakmak SE, Kaleagasi H, Siva A. Epidemiological-based childhood headache natural history study: after an interval of six years. Cephalalgia 2010; 30 (6) 703-712
    CrossrefPubMedGoogle Scholar
  • 10 Laurell K, Larsson B, Eeg-Olofsson O. Prevalence of headache in Swedish schoolchildren, with a focus on tension-type headache. Cephalalgia 2004; 24 (5) 380-388
    CrossrefPubMedGoogle Scholar
  • 11 Ellert U, Neuhauser H, Roth-Isigkeit A. [Schmerzen bei Kindern und Jugendlichen in Deutschland: Prävalenz und Inanspruchnahme medizinischer Leistungen. Ergebnisse des Kinder- und Jugendgesundheitssurveys (KiGGS)]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50 (5-6) 711-717
    PubMedGoogle Scholar
  • 12 Lewis DW. Headaches in children and adolescents. Curr Probl Pediatr Adolesc Health Care 2007; 37 (6) 207-246
    CrossrefPubMedGoogle Scholar
  • 13 Wöber-Bingöl C, Wöber C, Wagner-Ennsgraber C , et al. IHS criteria and gender: a study on migraine and tension-type headache in children and adolescents. Cephalalgia 1996; 16 (2) 107-112
    CrossrefPubMedGoogle Scholar
  • 14 Larsson B, Fichtel A. Headache prevalence and characteristics among school children as assessed by prospective paper diary recordings. J Headache Pain 2012; 13 (2) 129-136
    CrossrefPubMedGoogle Scholar
  • 15 Hoftun GB, Romundstad PR, Zwart JA, Rygg M. Chronic idiopathic pain in adolescence—high prevalence and disability: the young HUNT Study 2008. Pain 2011; 152 (10) 2259-2266
    CrossrefPubMedGoogle Scholar
  • 16 Hershey AD. Pediatric headache: update on recent research. Headache 2012; 52 (2) 327-332
    CrossrefPubMedGoogle Scholar
  • 17 Luntamo T, Sourander A, Rihko M , et al. Psychosocial determinants of headache, abdominal pain, and sleep problems in a community sample of Finnish adolescents. Eur Child Adolesc Psychiatry 2012; 21 (6) 301-313
    CrossrefPubMedGoogle Scholar
  • 18 Kujala UM, Taimela S, Viljanen T. Leisure physical activity and various pain symptoms among adolescents. Br J Sports Med 1999; 33 (5) 325-328
    CrossrefPubMedGoogle Scholar
  • 19 Laurell K, Larsson B, Eeg-Olofsson O. Headache in schoolchildren: association with other pain, family history and psychosocial factors. Pain 2005; 119 (1-3) 150-158
    CrossrefPubMedGoogle Scholar
  • 20 Powers SW, Gilman DK, Hershey AD. Headache and psychological functioning in children and adolescents. Headache 2006; 46 (9) 1404-1415
    CrossrefPubMedGoogle Scholar
  • 21 Roth-Isigkeit A, Thyen U, Stöven H, Schwarzenberger J, Schmucker P. Pain among children and adolescents: restrictions in daily living and triggering factors. Pediatrics 2005; 115 (2) e152-e162
    CrossrefPubMedGoogle Scholar
  • 22 Hagen K, Stovner LJ, Zwart JA. Potentials and pitfalls in analytical headache epidemiological studies—lessons to be learned from the Head-HUNT study. Cephalalgia 2007; 27 (5) 403-413
    CrossrefPubMedGoogle Scholar
  • 23 Neut D, Fily A, Cuvellier JC, Vallée L. The prevalence of triggers in paediatric migraine: a questionnaire study in 102 children and adolescents. J Headache Pain 2012; 13 (1) 61-65
    CrossrefPubMedGoogle Scholar
  • 24 Björling EA. The momentary relationship between stress and headaches in adolescent girls. Headache 2009; 49 (8) 1186-1197
    CrossrefPubMedGoogle Scholar
  • 25 Holzhammer J, Wöber C. [Non-alimentary trigger factors of migraine and tension-type headache]. Schmerz 2006; 20 (3) 226-237
    CrossrefPubMedGoogle Scholar
  • 26 Holzhammer J, Wöber C. [Alimentary trigger factors that provoke migraine and tension-type headache]. Schmerz 2006; 20 (2) 151-159
    CrossrefPubMedGoogle Scholar
  • 27 Wöber C, Holzhammer J, Zeitlhofer J, Wessely P, Wöber-Bingöl C. Trigger factors of migraine and tension-type headache: experience and knowledge of the patients. J Headache Pain 2006; 7 (4) 188-195
    CrossrefPubMedGoogle Scholar
  • 28 Milde-Busch A, Blaschek A, Borggräfe I, Heinen F, Straube A, von Kries R. Associations of diet and lifestyle with headache in high-school students: results from a cross-sectional study. Headache 2010; 50 (7) 1104-1114
    CrossrefPubMedGoogle Scholar
  • 29 Milde-Busch A, Blaschek A, Heinen F , et al. Associations between stress and migraine and tension-type headache: results from a school-based study in adolescents from grammar schools in Germany. Cephalalgia 2011; 31 (7) 774-785
    CrossrefPubMedGoogle Scholar
  • 30 Blaschek A, Milde-Busch A, Straube A , et al. Self-reported muscle pain in adolescents with migraine and tension-type headache. Cephalalgia 2012; 32 (3) 241-249
    CrossrefPubMedGoogle Scholar
  • 31 Headache Classification Subcommittee, International Headache Society. The International Classification of Headache Disorders, 2nd edition. Cephalalgia 2004; 24 (Suppl. 01) 9-160
    CrossrefPubMedGoogle Scholar
  • 32 von Zerssen D. Die Beschwerde-Liste. Manual. Weinheim, Germany: Beltz Test Gesellschaft; 1976
    Google Scholar
  • 33 Schulz P, Schlotz W, Becker P. TICS-Trierer Inventar zum chronischen Stress [Trier Inventory of Chronic Stress]. Manual. Goettingen, Germany: Hogrefe; 2004
    Google Scholar