Chronic daily headache in adolescents - Prevalence, impact, and medication overuse

Tzu Chi University, Hua-lien, Taiwan, Taiwan
Neurology (Impact Factor: 8.3). 01/2006; 66(2):193-7. DOI: 10.1212/01.wnl.0000183555.54305.fd
Source: PubMed

ABSTRACT To examine the prevalence, impact, and related medication use or overuse of primary chronic daily headache (CDH) among adolescents in a field sample.
The authors conducted a two-phase CDH survey of all students from ages 12 to 14 years in five selected middle schools in Taiwan. Subjects with CDH in the past year were identified and interviewed by neurologists. CDH was defined as headache occurring at a frequency of 15 days/month or more, average of 2 hours/day or more, for more than 3 months, and its subtypes were classified on the basis of the International Classification of Headache Disorders, 2nd edition.
Of the 7,900 participants, 122 (1.5%) fulfilled the criteria for primary CDH in the past year. Girls had a higher prevalence (2.4%) than boys (0.8%) (p < 0.001). Of the CDH subjects, 88 (72%) could be classified into either chronic tension-type headache (65.6%) or chronic migraine (6.6%). None of them fulfilled the criteria of new daily-persistent headache or hemicrania continua. Twenty-four subjects (20%) overused medications. Eighty-two (67%) of all CDH subjects had migraine or probable migraine. In the past semester, most CDH subjects (65%) did not take any sick leave for headaches. Only 6 subjects consulted neurologists in the past year, and only 1 subject took headache prophylactic agents.
Chronic daily headache (CDH) was common in a large nonreferred adolescent sample. Based on the International Classification of Headache Disorders, 2nd edition, criteria, chronic tension-type headache was the most common subtype; however, a majority of adolescents with CDH had headaches with features of migraine.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: The aim of this study was to evaluate the prevalence of headache in psychiatry clinics. Method: Three hundred and seventy two consecutive patients aged between 18 and 82 (Mean: 36.4±13.2) years were interviewed with a semi-structured interview form. All patients were asked whether they had headache or not. If they answered 'yes, the differential diagnosis of headache was made. Findings: Two-hundred and fifty-two patients (67.7%) did not complain any kind of headache. Migraine (13.7%, n=51) and tension type headaches (12.6%, n=47) were the most commonly seen headaches in psychiatry outpatient clinics. The frequency of migraine in subjects with anxiety di-sorder was higher than that in subjects with other psychiatric conditions including major depressi-on. The frequency of tension type headache was higher in subjects with anxiety disorder in com-parison to other psychiatric disorders, too. We found a statistically significant positive relationship between anxiety disorder or depression, and headache disorders (p<0.00). The tension type or chronic daily headache was seen at later ages but migraine in younger ages (p<0.00). The preva-lence of migraine was similar in psychiatry clinics and in the general population of Turkey previ-ously reported. The similar frequency of headache in psychiatry clinics is probably due to a comor-bidity with psychiatric diseases. Discussion and Conclusion: We concluded that it was important to ask standard questions abo-ut headache in the course of the anamnesis in patients with major depression and anxiety disor-der. ÖZET Psikiyatrik Bozuklu¤u Olan Türk Hastalarda Bafla¤r›s› S›kl›¤› Amaç: Bu çal›flman›n amac› psikiyatri klini¤inde bafla¤r›s› prevalans›n›n de¤erlendirilmesidir. Yöntem: Yafllar› 18 ile 82 y›l aras›nda de¤iflen (Ortalama: 36.4±13.2 y›l) ard› s›ra 372 hasta yar› ya-p›land›r›lm›fl form ile sorguland›. Tüm hastalara bafla¤r›lar› olup olmad›¤› soruldu. 'Evet' cevab› ve-renlerin bafla¤r›s› ay›r›c› tan›lar› yap›ld›. Bulgular: Hastalar›n 252'si (%67.7) hiç bir bafla¤r›s› çeflidi târif etmediler. Migren (%13.7, n=51) ve gerilim türü bafla¤r›s› (%12.6, n=47) psikiyatri polikliniklerinde en s›k rastlanan bafla¤r›lar› olarak bulundu. Majör depresyon dâhil olmak üzere di¤er psikiyatrik durumlara k›yasla anksiyete bozuk-lu¤u olgular›nda migren daha s›kt›. Di¤er psikiyatrik durumlara k›yasla anksiyete bozuklu¤u olgu-lar›nda gerilim türü bafla¤r›s› da daha s›kt›. Anksiyete bozuklu¤u ya da depresyon varl›¤› ile bafla¤-r›lar› aras›nda istatsitiksel olarak anlaml› ve pozitif yönde bir iliflki bulduk (p<0.00). Gerilim türü ba-fla¤r›s› daha ileri yafllarda gözlenirken migren daha genç yafllarda görülür (p<0.00). Psikiyatri Polik-lini¤i'ndeki migren prevalans› daha önce Türkiye'den bildirilmifl raporlara benzer biçimde bulun-du. Tart›flma ve Sonuç: Benzer s›kl›kta bafla¤r›s› varl›¤› psikiyatrik hastal›klarla bafla¤r›s› aras›ndaki
    Yeni Symposium 01/2010;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Medication-overuse headache (MOH) is a worldwide health problem with a prevalence of 1%-2%. It is a severe form of headache where the patients often have a long history of headache and of unsuccessful treatments. MOH is characterized by chronic headache and overuse of different headache medications. Through the years, withdrawal of the overused medication has been recognized as the treatment of choice. However, currently, there is no clear consensus regarding the optimal strategy for management of MOH. Treatment approaches are based on expert opinion rather than scientific evidence. This review focuses on aspects of epidemiology, diagnosis, pathogenesis, prevention, and treatment of MOH. We suggest that information and education about the risk of MOH is important since the condition is preventable. Most patients experience reduction of headache days and intensity after successful treatment. The first step in the treatment of MOH should be carried out in primary care and focus primarily on withdrawal, leaving prophylactic medication to those who do not manage primary detoxification. For most patients, a general practitioner can perform the follow-up after detoxification. More complicated cases should be referred to neurologists and headache clinics. Patients suffering with MOH have much to gain by an earlier treatment-focused approach, since the condition is both preventable and treatable.
    Journal of Pain Research 06/2014; 7:367-78. DOI:10.2147/JPR.S46071
  • [Show abstract] [Hide abstract]
    ABSTRACT: Purpose: This study describes a multivariate model showing how lifestyle behaviors (skipping meals, water intake, tobacco use, alcohol use, and physical activity) and illness-related factors (depression, somatic complaints, insomnia, and obesity) work together to predict headache in an adolescent population. Method: A descriptive, cross-sectional, secondary analysis using survey data from the National Longitudinal Study of Adolescent Health (1996) is reported. The National Longitudinal Study of Adolescent Health is a large database providing a nationally representative sample of adolescents (aged 11-17 years, n = 13,570). The database evaluated adolescent headache and is inclusive of all the predictors specific to this study. Frequency analysis and forward logistic regression were performed using each of the lifestyle behaviors and illness-related factors. Results: Approximately 26% of the adolescents experienced recurrent headache. Recurrent headache was reported by 19% of male adolescents and 26% of female adolescents. A multivariate model was developed that showed how lifestyle behaviors and illness-related factors predict recurrent headache in adolescents. The final model (Wald F = 86.88, p = .00) consisted of the following predictors: chest pain, muscle and joint pain, skip breakfast three or more times a week, skip lunch one or more times a week, and physical activity. The interactions of gender and age group, race and smoking regularly, and depression and insomnia were also included in the final model. Conclusion: Providing evidence to clinicians that lifestyle behaviors and illness-related factors are associated with adolescent headache may improve overall headache assessment and may result in a more comprehensive plan of treatment.
    Journal of Neuroscience Nursing 12/2014; 46(6):337-350. DOI:10.1097/JNN.0000000000000095 · 0.91 Impact Factor

Full-text (2 Sources)

Available from
Jun 11, 2014