Childhood Headache, Stress in Adolescence, and Primary Headache in Young Adulthood: A Longitudinal Cohort Study


  • Karen E. Waldie PhD

    1. From the Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
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Address all correspondence to Dr. Karen E. Waldie, DMHDRU, Department of Preventive and Social Medicine, University of Otago, PO Box 913, Dunedin, New Zealand.


Objectives.—To determine the association between childhood history of headache, adolescent stress, and headache syndromes (determined by International Headache Society criteria) in young adulthood.

Background.—The association between stress and tension-type headache has recently been challenged. Little is known about stress and other headache subtypes, particularly among young people from the general population.

Design.—Members of the longitudinal Dunedin Multidisciplinary Health and Development Study participated in this study. Study members were asked about headache characteristics/symptoms at aged 26 (96% of the living cohort), and historical records were examined to ascertain headache history (younger than 12 years) and the reporting of stressful life events at aged 15 years.

Results.—Study members with childhood headache were significantly more likely to report adolescent stress than those without headache. High-intensity stress during mid adolescence increased the likelihood of migraine diagnosis. In those with combined headache (migraine as well as tension-type headache), this relation held only for those with a history of headache. Stress associated with bodily changes during mid adolescence was the only significant predictor of tension-type headache.

Conclusions.—Childhood headaches are related to the appraisal of life events reported during mid adolescence. Childhood headaches also appear to confer a specific risk for the development of combined headache. There was little evidence for a prospective relation between stress in mid adolescence and tension-type headache in young adulthood, supporting claims that proximal (rather than distal) stress is associated with this disorder.