Headache in German Children and Adolescents: A Population-Based Epidemiological Study

Abstract

The aim of the present study was to assess the distribution and characteristics of headache in children aged 7-14 years in Lower Saxony (Germany). For the survey, 8800 households with children were randomly drawn from community registers. Parents received comprehensive questionnaires regarding various aspects of their child's headache history and general health by mail. The response rate was 63.5%. The 6-month prevalence of paediatric headache was 53.2% and increased with age (39% at 7 years to 63% at age 14). Overall, recurrent headache (> or =1/week) was experienced by 6.5% of the total sample and was significantly more common among older girls (> or =11 years) than their male counterparts. Boys and girls did not differ markedly from one another regarding headache occurrence and frequency until the age of 11. Mean age of headache onset was 7.5 years, with onset occurring at a significantly younger age among boys than among girls. In accordance with International Classification of Headache Disorders-II criteria, migraine was diagnosed in 7.5% and tension-type headache in 18.5% of the cases, hence a large proportion of the children had unclassifiable headache. Of the headache disorders, migraine was rated the most disabling, with the highest average intensity, highest frequency, duration of headache often exceeding 2 h and more frequent use of medication. In general, aura symptoms were rare except for visual disturbances (17%). Paediatric headache was strongly associated with other health problems, including other pain symptoms. Paediatric headache was also associated with a history of parental headache.

The Prediction of Clinically Relevant Anxiety Symptoms in Early Adulthood: Direct and Indirect Effects of Childhood and Parental Factors

“…Hence, complete psychometric tests often could not be applied. A subset of items from a variety of validated instruments was selected based on largest item-scale correlation coefficients or largest factor loadings [33].…”

“…Thus, within the conceptual model of the TVM, the aim of the current study was to examine a predictive model of adult anxiety including internalizing symptoms in childhood, dysfunctional parenting style as perceived by the child and as recalled by the child at a later time, parental worry as a habitual trait as reported by the parents during childhood time of their son or daughter and self-efficacy of the children [33]. Most studies on the significance of these variables for the manifestation of anxiety had some weaknesses regarding limitations in the operationalization of constructs, their cross-sectional study design or retrospectively assessed data [34,37].…”

“…Associations of lower selfefficacy with anxiety symptoms and disorders have been shown in several studies [22,23]. Thus, we expected a reduced sense of personal control in young children to constitute a mediator between a negative restrictive family environment, parents` worrying and subsequent negative affect and anxiety symptoms [24][25][26][27][28][29][30][31][32][33][34][35][36].…”

“…For detailed information regarding the questionnaire development, conduct of the study and initial data collection [33].…”

“…The Ethical Committee of the German Association of Psychology approved the study, as well as data safety procedures by the data protection representative of the University of Göttingen [33].…”