Tension Type Headache in Adolescence and Childhood: Where Are We Now?

UCSF Headache Center, University of California-San Francisco, 1701 Divisadero Street, San Francisco, CA 94115, USA.
Current Pain and Headache Reports (Impact Factor: 2.26). 10/2010; 14(6):424-30. DOI: 10.1007/s11916-010-0149-z
Source: PubMed


Tension type headache (TTH) is a primary headache disorder considered common in children and adolescents. It remains debatable whether TTH and migraine are separate biological entities. This review summarizes the most recent literature of TTH with regards to children and adolescents. Further studies of TTH are needed to develop a biologically based classification system that may be facilitated through understanding changes in the developing brain during childhood and adolescence.

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Available from: Teshamae S Monteith, Nov 05, 2014
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    • "Childhood headache disorders should be recognised as a significant health concern due to the considerable impact on the child and the family [10,11]. Compared to headache-free children, concerns include greater rates of absence from school [12,13], fewer and poorer peer relations including bullying [14-16], and general impairments in home life, school and leisure activities [17-20]. "
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    ABSTRACT: Background Though migraine and tension type headache are both commonly diagnosed in childhood, little is known about their determinants when diagnosed prior to puberty onset. Our aim was to determine psychosocial- and health-related risk factors of migraine and tension-type headache in 11 year old children. Methods 871 New Zealand European children were enrolled in a longitudinal study at birth and data were collected at birth, 1, 3.5, 7, and 11 years of age. Primary headache was determined at age 11 years based on the International Headache Society. Perinatal factors assessed were small for gestational age status, sex, maternal smoking during pregnancy, maternal perceived stress, and maternal school leaving age. Childhood factors assessed were sleep duration, percent body fat, television watching, parent and self-reported total problem behaviour, being bullied, and depression. Results Prevalence of migraine and tension-type headache was 10.5% and 18.6%, respectively. Both migraine and TTH were significantly associated with self-reported problem behaviour in univariable logistic regression analyses. Additionally, migraine was associated with reduced sleep duration, and both sleep and behaviour problems remained significant after multivariable analyses. TTH was also significantly associated with antenatal maternal smoking, higher body fat, and being bullied. For TTH, problem behaviour measured at ages 3.5 and 11 years both remained significant after multivariable analysis. Being born small for gestational age was not associated with either headache group. Conclusions Although they share some commonality, migraine and tension-type headache are separate entities in childhood with different developmental characteristics. The association between primary headache and problem behaviour requires further investigation.
    Full-text · Article · Sep 2014 · The Journal of Headache and Pain
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    • "It is not always easy to distinguish between migraine and TTH, especially not in children and adolescents. Altogether it has been debated whether such distinctions need to be made because there seem to be more similarities than differences [26]. Although we used a validated “recognition-based” headache diagnostic method in our study, misclassification may have had an impact on the supplementary analyses. "
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    ABSTRACT: Background It is well documented that both anxiety and depression are associated with headache, but there is limited knowledge regarding the relation between recurrent primary headaches and symptoms of anxiety and depression as well as behavioral problems among adolescents. Assessment of co-morbid disorders is important in order to improve the management of adolescents with recurrent headaches. Thus the main purpose of the present study was to assess the relationship of recurrent headache with anxiety and depressive symptoms and behavioral problems in a large population based cross-sectional survey among adolescents in Norway. Methods A cross-sectional, population-based study was conducted in Norway from 1995 to 1997 (Young-HUNT1). In Young-HUNT1, 4872 adolescents aged 12 to 17 years were interviewed about their headache complaints and completed a comprehensive questionnaire that included assessment of symptoms of anxiety and depression and behavioral problems, i.e. conduct and attention difficulties. Results In adjusted multivariate analyses among adolescents aged 12–14 years, recurrent headache was associated with symptoms of anxiety and depression (OR: 2.05, 95% CI: 1.61-2.61, p < 0.001), but not with behavioral problems. A significant association with anxiety and depressive symptoms was evident for all headache categories; i.e. migraine, tension-type headache and non-classifiable headache. Among adolescents aged 15–17 years there was a significant association between recurrent headache and symptoms of anxiety and depression (OR: 1.64, 95% CI: 1.39-1.93, p < 0,001) and attention difficulties (OR: 1.25, 95% CI: 1.09-1.44, p =0.001). For migraine there was a significant association with both anxiety and depressive symptoms and attention difficulties, while tension-type headache was significantly associated only with symptoms of anxiety and depression. Non-classifiable headache was associated with attention difficulties and conduct difficulties, but not with anxiety and depressive symptoms. Headache frequency was significantly associated with increasing symptoms scores for anxiety and depressive symptoms as well as attention difficulties, evident for both age groups. Conclusions The results from the present study indicate that both anxiety and depressive symptoms and behavioral problems are associated with recurrent headache, and should accordingly be considered a part of the clinical assessment of children and adolescents with headache. Identification of these associated factors and addressing them in interventions may improve headache management.
    Full-text · Article · Jun 2014 · The Journal of Headache and Pain
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    • "Prowadzi to do bólu głowy " z odbicia " , czyli ze zbytniego obciążenia organizmu lekami oraz uzależnienia się od analgetyków [18]. Innym istotnym czynnikiem wpływającym na pogorszenie jakości życia jest fakt, że bóle głowy typu napięciowego częściej występują u osób, u których stwierdzono migreny [19] [20]. Stwierdzono też współwystępowanie padaczki (chociaż częstsze jest współwystępowanie padaczki i migreny [21] [22] ), i inne. "
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    ABSTRACT: ABSTRACT Aim of this article is to summarize scientific knowledge about common but inconvenient illness which is tension type head-ache (TTH). This issue was undertaken due to difficulties in the medical and psychological diagnosis. It should be noted, that the main reason of ordering a psychological consultation is lack of clear reasons of headache. The article presents definitions of disease, diagnostic classifications and the review of etiology concpetions. What is more, we have shown the scale of the problem and its possible negative effects. It is also attempted to organize existing knowledge and research on the participa-tion of psychological factors (including the determinants of temperamental and the process of coping with stress) in the emergence of this disease.
    Full-text · Article · Jan 2011
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