Kröner-Herwig Birgit, Morris Lisette, Heinrich Marion
Georg-Elias-Müller-Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Göttingen, Göttingen, Germany.
Headache. 2008 Apr;48(4):529-44. doi: 10.1111/j.1526-4610.2007.00945.x. Epub 2007 Nov 27.
The study aims at identifying biopsychosocial risk factors for headache in children and adolescents aged 9 to 14.
An epidemiological survey was conducted in a randomly drawn population sample of families with children in the above age group. Questionnaires were mailed to parents and children (n=6400), on whose data this report is based. The objective of the study was to establish a profile of risk factors regarding the occurrence of headache. Headache, as the criterion variable, was ranked according to its frequency in the last 6 months (no, rare, monthly, weekly). Independent variables came from 6 domains: health, socioeconomic, family, school, leisure/peers, and psychological factors. Data analysis was conducted via multinomial regression analyses in a 4-step strategy: (1) analysis of age and sex as control variables; (2) analysis of single variables from each of the 6 domains (controlled for age and sex); (3) domain analyses; and (4) comprehensive analysis including all significant variables from the domain analyses.
Age and sex explained a small but significant proportion of the variance in headache frequency (3.5%). All health variables, several socioeconomic, and most family- and school-related as well as the psychological variables demonstrated a significant association with the criterion in the single variable models. However, only a few of the variables related to leisure/peer activities reached significance. The domain model comprising health variables explained 27% of the variance, achieving the best model fit, followed by the psychological model with 13%.
The comprehensive model was able to explain one third of the total variance in headache occurrence. Contrary to our hypothesis, the addition of psychosocial variables to health-related predictors did not markedly improve model fit.
本研究旨在确定9至14岁儿童和青少年头痛的生物心理社会风险因素。
对上述年龄组有孩子的家庭进行随机抽样的流行病学调查。向家长和孩子邮寄问卷（n = 6400），本报告基于这些数据。该研究的目的是建立头痛发生的风险因素概况。头痛作为标准变量，根据其在过去6个月内的发生频率进行排序（无、罕见、每月、每周）。自变量来自6个领域：健康、社会经济、家庭、学校、休闲/同伴和心理因素。数据分析通过多分类回归分析分4步进行：（1）将年龄和性别作为控制变量进行分析；（2）对6个领域中的每个领域的单一变量进行分析（控制年龄和性别）；（3）领域分析；（4）综合分析，包括领域分析中的所有显著变量。
年龄和性别解释了头痛频率变异的一小部分但显著的比例（3.5%）。在单变量模型中，所有健康变量、几个社会经济变量、大多数与家庭和学校相关的变量以及心理变量都与标准变量有显著关联。然而，与休闲/同伴活动相关的变量中只有少数达到显著水平。包含健康变量的领域模型解释了27%的变异，拟合效果最佳，其次是心理模型，解释了13%的变异。
综合模型能够解释头痛发生总变异的三分之一。与我们的假设相反，在与健康相关的预测因素中加入心理社会变量并没有显著改善模型拟合。
