Headache disability among adolescents: a student population-based study.

OBJECTIVE: To examine the extent and to identify the relevant predictors of headache disabilities in adolescents.

BACKGROUND: Headaches are common in adolescents but their impact and related factors have not been extensively studied in adolescent communities.

METHOD: We recruited and surveyed 3963 students aged 13-15 from 3 middle schools using self-administered questionnaires. The questionnaires were used to make 3 assessments: (1) headaches were diagnosed using a validated headache questionnaire; (2) headache disabilities were evaluated using the 6-question Pediatric Migraine Disability Assessment; (3) depression was measured using the Adolescent Depression Inventory.

RESULTS: The student response rate was 93%. In total, 484 students (12.2%) had migraines with or without auras, 444 (11.2%) had probable migraines, and 1092 (27.6%) had tension-type headaches. The students with migraine had the highest Pediatric Migraine Disability Assessment scores (10.7 +/- 20.0); whereas, the students with tension-type headaches had the lowest scores (2.0 +/- 4.4). Logistic regression analyses indicated that there were a number of independent predictors for moderate to severe headache-related disability (Pediatric Migraine Disability Assessment score > or =31), including a migraine or probable migraine diagnosis, a higher depression score, severe headache intensity, and frequent headaches.

CONCLUSIONS: The Pediatric Migraine Disability Assessment provides a simple tool to measure the impact of headaches in adolescents. Adolescents with migraine headaches suffered the greatest level of disability. Higher depression scores were associated with more severe headache-related disabilities in adolescents, independent of headache frequency and severity.