Paediatric headache trajectories – a reappraisal after nine years

Abstract

Background The long-term consequences of paediatric headache can involve functional disabilities and mental health problems in adulthood. Objective To analyse the predictive power of paediatric headache trajectory classes for headache and related outcomes in adulthood. Methods In a previous study, a population-based sample (N = 3227, 9-14 years of age at first assessment) was followed across four annual assessment points, and sex-specific headache trajectory classes were identified (girls: "no pain", "moderate pain", "increasing pain", "high pain"; boys: "no pain", "moderate pain"). These trajectory classes were used to predict headache frequency, functional disability, depression, quality of life and self-efficacy nine years later (N = 994). Negative binomial regression analyses and pairwise comparisons were computed. Results Women showing an elevated trajectory ("increasing pain" or "high pain") had a higher adult headache frequency and a poorer outcome on associated variables (functional disability, depression, quality of life, and self-efficacy) than women having a lower-level trajectory. Men of the "no pain" and "moderate pain" trajectory classes differed significantly from one another in their headache frequency and related variables. Conclusion Belonging to an elevated paediatric headache trajectory class involves a considerable risk for headache and headache-related problems in adulthood.

Mother‐reported pain experience between ages 7 and 10: A prospective study in a population‐based birth cohort

“…In terms of the typology and relative frequency of major pain forms, our study is also in agreement with previous groupings in adolescents 7‐9 . We described 11 statistical clusters that use sex at birth and multiple pain features to improve discrimination.…”

“…In terms of the typology and relative frequency of major pain forms, our study is also in agreement with previous groupings in adolescents. [7][8][9] We described 11 statistical clusters that use sex at birth and multiple pain features to improve discrimination. For comparison purposes, these can be summarised in four larger groups: five clusters grouping a majority of children without recurrent pain, two with decreasing pain between ages 7 and 10, two with increasing pain, and the remaining two clusters comprising those with recurrent pain in both evaluations.…”

“… 7‐9 In the United States, four to six different trajectories were identified including a majority of adolescents without relevant complaints, a considerable proportion with transient pain, and a smaller group with persistent pain 7 . Four low back pain clusters (low, increasing, decreasing, and high level) were also described in Australia, 8 and a similar typology was found for headache in German girls 9 . Overall, trajectory studies argue for a considerable stability of persistent or recurrent pain as early as in adolescence.…”

“…5 Although most evidence on paediatric pain prognosis has been obtained in clinical settings, 6 a few prospective studies have described the course of pain in cohorts selected independently of initial symptoms. [7][8][9] In the United States, four to six different trajectories were identified including a majority of adolescents without relevant complaints, a considerable proportion with transient pain, and a smaller group with persistent pain. 7 Four low back pain clusters (low, increasing, decreasing, and high level) were also described in Australia, 8 and a similar typology was found for headache in German girls.…”

“…7 Four low back pain clusters (low, increasing, decreasing, and high level) were also described in Australia, 8 and a similar typology was found for headache in German girls. 9 Overall, trajectory studies argue for a considerable stability of persistent or recurrent pain as early as in adolescence. This points to the first decade of life as an important aetiologic window for shaping future pain.…”