Headache Disability Among Adolescents: A Student Population-Based Study

Authors

  • Jong-Ling Fuh MD,

    1. From Department of Neurology, the Neurological Institute (J-L. Fuh, S-J. Wang, and S-P. Chen); Taipei Veterans General Hospital, Taipei, Taiwan; the Department of Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan (S-R. Lu); Department of Neurology, Taichung Veterans General Hospital, Taiwan (Y-C. Liao), Division of Psychiatry, Ton Yen General Hospital, Taiwan (C-Y. Yang) and National Yang-Ming University School of Medicine, Taipei, Taiwan (J-L. Fuh, S-J. Wang, Y-C. Liao, and S-P. Chen).
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  • Shuu-Jiun Wang MD,

    1. From Department of Neurology, the Neurological Institute (J-L. Fuh, S-J. Wang, and S-P. Chen); Taipei Veterans General Hospital, Taipei, Taiwan; the Department of Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan (S-R. Lu); Department of Neurology, Taichung Veterans General Hospital, Taiwan (Y-C. Liao), Division of Psychiatry, Ton Yen General Hospital, Taiwan (C-Y. Yang) and National Yang-Ming University School of Medicine, Taipei, Taiwan (J-L. Fuh, S-J. Wang, Y-C. Liao, and S-P. Chen).
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  • Shiang-Ru Lu MD,

    1. From Department of Neurology, the Neurological Institute (J-L. Fuh, S-J. Wang, and S-P. Chen); Taipei Veterans General Hospital, Taipei, Taiwan; the Department of Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan (S-R. Lu); Department of Neurology, Taichung Veterans General Hospital, Taiwan (Y-C. Liao), Division of Psychiatry, Ton Yen General Hospital, Taiwan (C-Y. Yang) and National Yang-Ming University School of Medicine, Taipei, Taiwan (J-L. Fuh, S-J. Wang, Y-C. Liao, and S-P. Chen).
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  • Yi-Chu Liao MD,

    1. From Department of Neurology, the Neurological Institute (J-L. Fuh, S-J. Wang, and S-P. Chen); Taipei Veterans General Hospital, Taipei, Taiwan; the Department of Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan (S-R. Lu); Department of Neurology, Taichung Veterans General Hospital, Taiwan (Y-C. Liao), Division of Psychiatry, Ton Yen General Hospital, Taiwan (C-Y. Yang) and National Yang-Ming University School of Medicine, Taipei, Taiwan (J-L. Fuh, S-J. Wang, Y-C. Liao, and S-P. Chen).
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  • Shih-Pin Chen MD,

    1. From Department of Neurology, the Neurological Institute (J-L. Fuh, S-J. Wang, and S-P. Chen); Taipei Veterans General Hospital, Taipei, Taiwan; the Department of Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan (S-R. Lu); Department of Neurology, Taichung Veterans General Hospital, Taiwan (Y-C. Liao), Division of Psychiatry, Ton Yen General Hospital, Taiwan (C-Y. Yang) and National Yang-Ming University School of Medicine, Taipei, Taiwan (J-L. Fuh, S-J. Wang, Y-C. Liao, and S-P. Chen).
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  • Chin-Yi Yang MD

    1. From Department of Neurology, the Neurological Institute (J-L. Fuh, S-J. Wang, and S-P. Chen); Taipei Veterans General Hospital, Taipei, Taiwan; the Department of Neurology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan (S-R. Lu); Department of Neurology, Taichung Veterans General Hospital, Taiwan (Y-C. Liao), Division of Psychiatry, Ton Yen General Hospital, Taiwan (C-Y. Yang) and National Yang-Ming University School of Medicine, Taipei, Taiwan (J-L. Fuh, S-J. Wang, Y-C. Liao, and S-P. Chen).
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  • Conflict of Interest: None

J-L. Fuh, the Neurological Institute, Taipei Veterans General Hospital, Taipei, 112, Taiwan.

Abstract

(Headache 2010;50:210-218)

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.

Method.— 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 valuated 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 ≥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.

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