One-year incidence, course, and outcome predictors of frequent headaches among early adolescents

Objective.-To examine the prevalence rate, course, annual incidence, and predictors of frequent headaches (at least once a week) in a 1-year longitudinal study of a representative school sample of 2355 adolescents aged 12 to 14 years. Methods.-Information was gathered by means of questionnaires administered to the subjects at school. Results.-The overall prevalence estimates of frequent headaches, including those subjects reporting another type of frequent pain, were 8.1% and 8.9% at the two assessment points (T-1 and T-2), and 3.3% to 4% for frequent headaches without other frequent pain complaints. Both forms of frequent headaches were about three times more common among girls than boys. Persistence of frequent headaches (with possible pain comorbidity) was high, in that more than one-third of adolescents reporting frequent headaches continued to have such headaches 1 year later. Persistence also increased with age, in particular among 13- to 14-year-old girls. The overall annual incidence of frequent headaches in the whole sample was 6.5%. While incidence was about twice as high among adolescent girls than boys, there was a steady increase among girls, whereas the rates were stable in boys. The results of multivariate regression analyses showed that frequent headaches at 1-year follow-up could be significantly predicted by frequent headaches at first assessment, impairment (reduced leisure time activities), and high depressive symptom scores, in addition to gender (girls had a worse outcome). Conclusions.-Frequent headaches, among girls in early adolescence in particular, should be carefully evaluated, and treatment offered to those who are impaired in their daily life functioning.