From the Institute of Social Pediatrics and Adolescent Medicine, Ludwig-Maximilians-University, Munich, Germany.
Headache. 2010 May;50(5):738-48. doi: 10.1111/j.1526-4610.2009.01605.x. Epub 2010 Jan 20.
Headache is commonly voiced by adolescents and is known to be associated with reduced quality of life. Otherwise, there are only limited data regarding associations between different types of headache and psychopathological symptoms in adolescents.
Aim of the present study in adolescents was to assess the impact of headache on psychopathological symptoms and whether these differ between types of headache.
Data were derived from a population-based sample (n = 1047, ages 13-17 years). Type of headache (ie, migraine, tension-type headache, miscellaneous headache) was ascertained for subjects reporting headache episodes at least once per month. Psychopathological symptoms were assessed with the Strengths and Difficulties Questionnaire. The following dimensions were taken into account: emotional symptoms, conduct problems, hyperactivity/inattention, peer problems (these 4 add to the total difficulties score), and prosocial behavior. Associations were estimated with logistic regression models with adjustment for age group, sex, and family situation.
Headache at least once per month was reported by 47.8% of the adolescents. Subjects with any headache were found to be at higher risk for emotional symptoms (odds ratio 1.5; 95% confidence interval 1.0-2.2) and hyperactivity/inattention (1.4; 1.0-1.9), resulting in a higher total difficulties score (1.6; 1.1-2.4). While the risk for psychopathological symptoms was not significantly increased in subjects with tension-type headache compared with subjects without headache, significant associations with emotional symptoms were found in subjects with migraine (2.9; 1.3-6.2; total difficulties score: 3.1; 1.4-6.8). Miscellaneous headache was associated with a broad spectrum of psychopathological symptoms: emotional symptoms (1.8; 1.0-3.3), conduct problems (1.6; 1.0-2.6), hyperactivity/inattention (1.9; 1.2-3.1), total difficulties score (2.7; 1.6-5.6).
Previously reported associations between headache and psychopathological symptoms in adolescents could be confirmed, but might vary with type of headache. As psychopathological symptoms may be a precursor for manifest psychiatric disorders, adolescents particularly with migraine and miscellaneous headache appear to be a vulnerable population.
头痛在青少年中很常见，已知与生活质量下降有关。然而，关于青少年不同类型的头痛与心理病理症状之间的关联，仅有有限的数据。
本研究旨在评估青少年头痛对心理病理症状的影响，以及不同类型的头痛是否存在差异。
数据来自基于人群的样本（n=1047，年龄 13-17 岁）。对于每月至少报告一次头痛发作的受试者，确定头痛类型（即偏头痛、紧张型头痛、其他头痛）。使用长处和困难问卷评估心理病理症状。考虑了以下维度：情绪症状、行为问题、多动/注意力不集中、同伴问题（这些加起来是总困难评分）和亲社会行为。使用逻辑回归模型进行关联估计，并调整年龄组、性别和家庭状况。
47.8%的青少年每月至少报告一次头痛。有任何头痛的受试者出现情绪症状（优势比 1.5；95%置信区间 1.0-2.2）和多动/注意力不集中（1.4；1.0-1.9）的风险更高，导致总困难评分（1.6；1.1-2.4）更高。虽然与无头痛的受试者相比，紧张型头痛受试者的心理病理症状风险没有显著增加，但偏头痛受试者与情绪症状显著相关（2.9；1.3-6.2；总困难评分：3.1；1.4-6.8）。其他头痛与广泛的心理病理症状相关：情绪症状（1.8；1.0-3.3）、行为问题（1.6；1.0-2.6）、多动/注意力不集中（1.9；1.2-3.1）、总困难评分（2.7；1.6-5.6）。
本研究可以证实先前报道的青少年头痛与心理病理症状之间的关联，但可能因头痛类型而异。由于心理病理症状可能是明显精神障碍的前兆，因此偏头痛和其他头痛的青少年似乎是一个脆弱的群体。
