奥地利儿童和青少年头痛的患病率和负担 - 10-18 岁学生代表性样本的全国性研究。
Prevalence and burden of headache in children and adolescents in Austria - a nationwide study in a representative sample of pupils aged 10-18 years.
机构信息
Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
出版信息
J Headache Pain. 2019 Nov 6;20(1):101. doi: 10.1186/s10194-019-1050-8.
BACKGROUND
Headache disorders are highly prevalent worldwide, but not so well investigated in children and adolescents as in adults: few studies have included representative nationwide samples. No data exist for Austria until now. In a representative sample of children and adolescents in Austria, we estimated the prevalence and attributable burden of headache disorders, including the new diagnostic category of "undifferentiated headache" (UdH) defined as mild headache lasting less than 1 hour.
METHODS
Within the context of a broader national mental health survey, children and adolescents aged 10-18 years were recruited from purposively selected schools. Mediated self-completed questionnaires included sociodemographic enquiry (gender, age, socioeconomic status, family constellation, residence [urban or rural] and migration background). Prevalence and attributable burden of all headache, UdH, migraine (definite plus probable), tension-type headache (TTH: definite plus probable) and headache on ≥15 days/month (H15+) were assessed using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire for children and adolescents. Health-related quality of life (HrQoL) was assessed using the KIDSCREEN questionnaire.
RESULTS
Of 7643 selected pupils, 3386 (44.3%) completed the questionnaires. The 1-year prevalence of headache was 75.7%, increasing with age and higher in girls (82.1%) than in boys (67.7%; p < 0.001). UdH, migraine, TTH and H15+ were reported by 26.1%, 24.2%, 21.6% and 3.0% of participants. Attributable burden was high, with 42% of those with headache experiencing restrictions in daily activities. Medication use (50% overall) was highest in H15+ (67%) and still considerable in UdH (29%). HrQoL was reduced for all headache types except UdH. Participants in single parent or patchwork families had a higher probability of migraine (respectively, OR 1.5, p < 0.001; OR 1.5, p < 0.01). Participants with a migration background had a lower probability of TTH (OR 0.7, p < 0.01).
CONCLUSIONS
Headache disorders are both very common and highly burdensome in children and adolescents in Austria. This study contributes to the global atlas of headache disorders in these age groups, and corroborates and adds knowledge of the new yet common and important diagnostic category of UdH. The findings call for action in national and international health policies, and for further epidemiological research.
背景
头痛障碍在全球范围内非常普遍，但在儿童和青少年中的研究不如在成年人中那么多：很少有研究包括具有代表性的全国性样本。直到现在，奥地利还没有相关数据。在奥地利的一个具有代表性的儿童和青少年样本中，我们估计了头痛障碍的患病率和可归因负担，包括新的诊断类别“未分化头痛”（UdH），定义为持续时间少于 1 小时的轻度头痛。
方法
在一项更广泛的国家心理健康调查的背景下，从有目的选择的学校中招募了 10-18 岁的儿童和青少年。经中介的自我完成的问卷包括社会人口学调查（性别、年龄、社会经济地位、家庭结构、居住地[城市或农村]和移民背景）。使用儿童和青少年头痛归因限制、残疾、社会障碍和参与受损（HARDSHIP）问卷评估所有头痛、UdH、偏头痛（明确加可能）、紧张型头痛（TTH：明确加可能）和头痛≥15 天/月（H15+）的患病率和可归因负担。使用 KIDSCREEN 问卷评估健康相关生活质量（HrQoL）。
结果
在选定的 7643 名小学生中，有 3386 名（44.3%）完成了问卷。头痛的 1 年患病率为 75.7%，随着年龄的增长而增加，女孩（82.1%）高于男孩（67.7%；p<0.001）。26.1%、24.2%、21.6%和 3.0%的参与者报告了 UdH、偏头痛、TTH 和 H15+。头痛患者的归因负担很高，有 42%的人在日常活动中受到限制。药物使用率（总体 50%）在 H15+（67%）和 UdH（29%）中最高。除 UdH 外，所有头痛类型的 HrQoL 均降低。单亲或拼凑家庭的参与者偏头痛的可能性更高（分别为 OR 1.5，p<0.001；OR 1.5，p<0.01）。有移民背景的参与者 TTH 的可能性较低（OR 0.7，p<0.01）。
结论
头痛障碍在奥地利的儿童和青少年中既非常普遍，又负担沉重。本研究为这些年龄组的全球头痛障碍图谱做出了贡献，并证实和增加了对新的但常见和重要的诊断类别 UdH 的认识。这些发现呼吁在国家和国际卫生政策中采取行动，并进一步开展流行病学研究。
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