Predictors and concomitants of the remission of frequent headache in pediatrics: A longitudinal community study

• Published in: Headache Vol. 64; no. 3; pp. 306 - 316
• Main Authors: Rau, Lisa‐Marie, Humberg, Clarissa, Könning, Anna, Claus, Benedikt B., Stahlschmidt, Lorin, Wager, Julia
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-03-2024
• Subjects: Adolescent; Adolescents; Anxiety; Case-Control Studies; Child; chronic pain; Confidence intervals; Depression - complications; Depression - epidemiology; frequent headache; Headache; Headache - diagnosis; Headache - epidemiology; Headache - therapy; Headaches; Humans; longitudinal; Longitudinal Studies; Male; Mental depression; Pain; Pain - epidemiology; pediatric; Pediatrics; Physiology; Predictive control; Psychotherapy; Remission; Sex; Sex ratio; Sleep; Teenagers; frequent headache; chronic pain; longitudinal; adolescents; remission; pediatric
• ISSN: 0017-8748; 1526-4610
• DOI: 10.1111/head.14690

Objective
We aimed to examine factors associated with frequent headache remission in schoolchildren aged 10–18 years.
Background
Frequent headache is a common health problem in adolescence, and some individuals in this population experience remission. Factors preceding headache remission as opposed to ongoing headache, and their development over time, have not been examined extensively.
Methods
Data were derived from a large school sample (N = 2280). Over the course of 1 year, n = 156 adolescents experienced remission from frequent headaches, while n = 125 adolescents continued to have frequent headaches throughout the year. In this longitudinal case–control study, we predicted headache remission using demographic, pain, psychosocial, sleep, and physiological characteristics. Additionally, we sought to explore the development of psychosocial, sleep, and physiological characteristics in relation to remitted versus ongoing headache over the 1‐year period.
Results
A model containing the variables sex (odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.248–0.76, p = 0.003), headache intensity (OR = 0.85, 95% CI = 0.73–0.99, p = 0.035), anxiety score (OR = 0.92, 95% CI = 0.85–1.01, p = 0.071), and depression score (OR = 0.94, 95% CI = 0.89–1.00, p = 0.041) predicted the outcome variable (remitted vs. non‐remitted headache), explaining 17% of the variance in group membership. Schoolchildren reporting remitted headache at the end of the year exhibited lower depression (F[1, 557.01] = 45.77, p < 0.001) and anxiety scores (F[1, 557.01] = 21.72, p < 0.001), higher school satisfaction (F[1, 209.46] = 7.15, p = 0.008), and fewer difficulties falling asleep (F[1, 856.52] = 41.21, p < 0.001) or sleeping through the night (F[1, 731.12] = 26.42, p < 0.001) throughout the year compared to those with non‐remitted headache. Depression scores declined significantly over the year in the group with remitted headache, whereas these scores remained constant in the group with non‐remitted headache.
Conclusion
Our results suggest a correlation between headache remission and male sex, improved mental health, and reduced pain‐related burden. Moreover, there was an observed decline in symptoms of depression during headache remission. Psychotherapy may be a promising treatment strategy for addressing frequent headaches reported by children and adolescents.
Plain Language Summary
Our goal was to find out why some kids aged 10–18 years stop having frequent headaches, which is why we asked 2280 schoolchildren to fill out a survey five times during the school year. Kids who stopped having frequent headaches were more often boys, had better mental health, and were not bothered as much by pain. The results suggest that psychotherapy might help kids and teens who get a lot of headaches.