Background
Methods
Sample selection and recruitment
Instruments
Headache and associated burden
Headache diagnoses
Sociodemographic variables
Health-related quality of life
Statistical analyses
Results
Sample characteristics
n (%) | Headache (any type) during the preceding year (%) | |||
---|---|---|---|---|
Yes | No | p | ||
Total | 3386 (100%) | 75.7% | 24.3% | |
Gender | ||||
Girls | 1874 (55.4%) | 82.1% | 17.9% | Chi2 = 93.9, p < 0.001 |
Boys | 1500 (44.5%) | 67.7% | 32.3% | |
Missing | 12 | |||
School grade | ||||
5th grade | 496 (14.6%) | 63.9% | 36.1% | Chi2 = 49.9, p < 0.001 |
7th grade | 865 (25.5%) | 77.3% | 22.7% | |
9th grade | 1087 (32.1%) | 75.6% | 24.4% | |
11th grade | 938 (27.7%) | 80.4% | 19.6% | |
Socioeconomic statusa | ||||
Low | 766 (23.4%) | 76.2% | 23.8% | Chi2 = 0.4, p = 0.808 |
Medium | 1750 (53.5%) | 76.1% | 23.9% | |
High | 756 (23.1%) | 75.0% | 25.0% | |
Missing | 114 | |||
Family constellation | ||||
Both biological parents | 2437 (74.3%) | 74.8% | 25.2% | Chi2 = 7.2, p = 0.027 |
Single parent | 547 (16.7%) | 78.8% | 21.2% | |
Patchwork | 295 (9.0%) | 79.7% | 20.3% | |
Missing | 107 | |||
Place of residencea | ||||
Urban | 1955 (58.5%) | 75.9% | 24.1% | Chi2 = 0.4, p = 0.524 |
Rural | 1385 (41.5%) | 74.9% | 25.1% | |
Missing | 46 | |||
Migration backgrounda | ||||
No | 2470 (74.3%) | 76.4% | 23.6% | Chi2 = 2.9, p = 0.088 |
Yes | 855 (25.7%) | 73.5% | 26.5% | |
Missing | 61 |
Prevalence of headache
Headache type | Total sample | Girls | Boys | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Total | 5th grade | 7th grade | 9th grade | 11th grade | Total | 5th grade | 7th grade | 9th grade | 11th grade | ||
UdH | 26.1 [24.6;27.6] | 26.5 [24.5;28.5] | 32.8 [26.8;38.8] | 31.5 [27.1;35.9] | 23.7 [20.4;27.0] | 23.3 [19.8;26.8] | 25.5 [23.3;27.7] | 23.8 [18.6;29.0] | 31.2 [26.8;35.6] | 22.4 [18.5;26.3] | 23.7 [19.4;28.0] |
All migraine | 24.2 [22.8;25.6] | 28.1 [26.1;30.1] | 18.1 [13.2;23.0] | 23.1 [19.1;27.1] | 31.4 [27.8;35.0] | 32.5 [28.6;36.4] | 19.5 [17.5;21.5] | 17.2 [12.6;21.8] | 21.2 [17.3;25.1] | 18.8 [15.2;22.4] | 19.9 [15.8;24.0] |
Definite migraine | 6.3 [5.5;7.1] | 6.9 [5.8;8.0] | 10.1 [6.3;13.9] | 5.3 [3.2;7.4] | 5.3 [3.6;7.0] | 8.7 [6.4;11.0] | 5.5 [4.3;6.7] | 10.9 [7.1;14.7] | 4.7 [2.7;6.7] | 4.1 [2.7;6.7] | 4.3 [2.2;6.4] |
Probable migraine | 18.0 [16.7;19.3] | 21.2 [19.3;23.1] | 8.0 [4.5;11.5] | 17.8 [14.2;21.4] | 26.1 [22.7;29.5] | 23.8 [20.3;27.3] | 14.0 [12.2;15.8] | 6.3 [3.3;9.3] | 16.5 [13.0;20.0] | 14.7 [11.4;18.0] | 15.6 [11.9;19.3] |
All TTH | 21.6 [20.2;23.0] | 22.4 [20.5;24.3] | 14.3 [9.8;18.8] | 23.1 [19.1;27.1] | 22.0 [18.8;25.2] | 25.6 [22.0;29.2] | 20.7 [18.6;22.8] | 15.6 [11.6;20.1] | 18.1 [14.5;21.7] | 20.4 [16.6;24.2] | 27.4 [22.9;31.9] |
Definite TTH | 15.1 [13.9;16.3] | 15.2 [13.6;16.8] | 8.4 [4.9;11.9] | 14.4 [11.1;17.7] | 15.0 [12.2;17.8] | 19.0 [15.8;22.2] | 14.9 [13.1;16.7] | 12.9 [8.8;17.0] | 13.7 [10.4;17.0] | 13.1 [10.0;16.2] | 19.9 [15.8;24.0] |
Probable TTH | 6.5 [5.7;7.3] | 7.2 [6.0;8.4] | 5.9 [2.9;8.9] | 8.8 [6.1;11.5] | 7.0 [5.0;9.0] | 6.6 [4.5;8.7] | 5.7 [4.5;6.9] | 2.7 [0.7;4.7] | 4.4 [2.5;6.3] | 7.2 [4.8;9.6] | 7.5 [4.8;10.2] |
All H15+ | 3.0 [2.4;3.6] | 4.1 [3.2;5.0] | 4.2 [1.6;6.8] | 3.0 [1.4;4.6] | 5.5 [3.7;7.3] | 3.2 [1.7;4.7] | 1.7 [1.0;2.4] | 0.8 [0.0;1.9] | 1.4 [0.3;2.5] | 2.3 [0.9;3.7] | 1.9 [0.5;3.3] |
pMOH | 0.9 [0.6;1.2] | 1.0 [0.5;1.5] | 0.4 [0.0;1.2] | 0.5 [0.0;1.2] | 1.2 [0.4;2.0] | 1.4 [0.4;2.4] | 0.9 [0.4;1.4] | 0.8 [0.0;1.9] | 0.5 [0.0;1.2] | 1.4 [0.3;2.5] | 0.8 [0.0;1.7] |
Other H15+ | 2.0 [1.5;2.5] | 3.0 [2.2;3.8] | 3.8 [1.4;6.2] | 2.5 [1.0;4.0] | 4.2 [2.6;5.8] | 1.8 [0.7;2.9] | 0.8 [0.3;1.3] | 0.0 | 0.9 [0.0;1.8] | 0.9 [0.0;1.8] | 1.1 [0.0;2.2] |
Unclassifiable | 0.7 [0.4;1.0] | 1.0 [0.5;1.5] | 1.3 [0.0;2.7] | 1.6 [0.4;2.8] | 0.8 [0.1;1.5] | 0.7 [0.0;1.4] | 0.4 [0.1;0.7] | 0.4 [0.0;1.2] | 0.5 [0.0;1.2] | 0.5 [0.0;1.2] | 0.3 [0.0;0.9] |
Headache type | Proportions of those with any headache (N = 2562) | |||
---|---|---|---|---|
5th grade (n = 317) | 7th grade (n = 669) | 9th grade (n = 822) | 11th grade (n = 754) | |
UdH | 44.2%a | 40.5%a | 30.8%b | 29.2%b |
All migraine | 27.4%a | 28.5%a | 34.6%a | 34.2%a |
Definite migraine | 16.4%a | 6.4%b | 6.3%b | 8.6%b |
Probable migraine | 11.0%a | 22.1%b | 28.3%c | 25.6%b,c |
All TTH | 23.3%a | 26.7%a,b | 28.3%a,b | 32.6%b |
Definite TTH | 16.7%a,b | 18.2%b | 18.9%a,b | 24.0%a |
Probable TTH | 6.6%a | 8.5%a | 9.4%a | 8.6%a |
All H15+ | 3.7%a | 2.8%a | 5.5%a | 3.4%a |
pMOH | 0.9%a | 0.6%a | 1.7%a | 1.5%a |
Other H15+ | 2.8%a | 2.2%a | 3.8%a | 1.9%a |
Unclassifiable | 1.3%a | 1.3%a | 0.9%a | 0.7%a |
Sociodemographic correlates
b (SE) | 95% CI for Odds Ratio | |||
---|---|---|---|---|
Lower | OR | Upper | ||
UdH vs no UdH (Nagelkerke R2 = .018; Model Chi2 = 37.79; p < 0.001) | ||||
Intercept | −1.08 (0.15)*** | |||
Female gender (ref male) | 0.05 (0.08) | 0.9 | 1.1 | 1.2 |
School grade (ref 5th grade) | ||||
7th grade | 0.17 (0.13) | 0.9 | 1.2 | 1.5 |
9th grade | −0.22 (0.13) | 0.6 | 0.8 | 1.0 |
11th grade | −0.26 (0.14) | 0.6 | 0.8 | 1.0 |
Socioeconomic status (ref high) | ||||
Medium | 0.12 (0.11) | 0.9 | 1.1 | 1.4 |
Low | 0.26 (0.13)* | 1.0 | 1.3 | 1.7 |
Family constellation (ref both parents) | ||||
Single parent | −0.24 (0.12)* | 0.6 | 0.8 | 1.0 |
Patchwork | −0.33 (0.16)* | 0.5 | 0.7 | 1.0 |
Urban place of residence (ref rural) | −0.05 (0.09) | 0.8 | 1.0 | 1.1 |
Migration background (ref no) | 0.21 (0.10)* | 1.0 | 1.2 | 1.5 |
Migraine vs no migraine (Nagelkerke R2 = .031; Model Chi2 = 63.69; p < 0.001) | ||||
Intercept | −1.87 (0.16)*** | |||
Female gender (ref male) | 0.39 (0.09)*** | 1.2 | 1.5 | 1.8 |
School grade (ref 5th grade) | ||||
7th grade | 0.32 (0.15)* | 1.0 | 1.4 | 1.8 |
9th grade | 0.49 (0.15)** | 1.2 | 1.6 | 2.2 |
11th grade | 0.52 (0.15)*** | 1.3 | 1.7 | 2.2 |
Socioeconomic status (ref high) | ||||
Medium | −0.07 (0.11) | 0.8 | 0.9 | 1.1 |
Low | −0.11 (0.13) | 0.7 | 0.9 | 1.2 |
Family constellation (ref both parents) | ||||
Single parent | 0.41 (0.11)*** | 1.2 | 1.5 | 1.9 |
Patchwork | 0.40 (0.14)** | 1.1 | 1.5 | 2.0 |
Urban place of residence (ref rural) | 0.12 (0.09) | 0.9 | 1.1 | 1.3 |
Migration background (ref no) | 0.01 (0.10) | 0.8 | 1.0 | 1.2 |
TTH vs no TTH (Nagelkerke R2 = .023; Model Chi2 = 45.50; p < 0.001) | ||||
Intercept | −1.56 (0.17)*** | |||
Female gender (ref male) | 0.12 (0.10) | 0.9 | 1.1 | 1.4 |
School grade (ref 5th grade) | ||||
7th grade | 0.37 (0.16)* | 1.1 | 1.4 | 2.0 |
9th grade | 0.43 (0.16)** | 1.1 | 1.5 | 2.1 |
11th grade | 0.73 (0.16)*** | 1.5 | 2.1 | 2.8 |
Socioeconomic status (ref high) | ||||
Medium | −0.11 (0.11) | 0.7 | 0.9 | 1.1 |
Low | −0.16 (0.14) | 0.7 | 0.9 | 1.1 |
Family constellation (ref both parents) | ||||
Single parent | −0.02 (0.12) | 0.8 | 1.0 | 1.3 |
Patchwork | 0.02 (0.16) | 0.8 | 1.0 | 1.4 |
Urban place of residence (ref rural) | −0.12 (0.09) | 0.7 | 0.9 | 1.1 |
Migration background (ref no) | −0.34 (0.11)** | 0.6 | 0.7 | 0.9 |
H15+ vs. no H15+ (Nagelkerke R2 = .037; Model Chi2 = 26.59; p = 0.003) | ||||
Intercept | −3.97 (0.41)*** | |||
Female gender (ref male) | 0.86 (0.25)** | 1.4 | 2.4 | 3.8 |
School grade (ref 5th grade) | ||||
7th grade | −0.29 (0.38) | 0.4 | 0.7 | 1.6 |
9th grade | 0.23 (0.34) | 0.7 | 1.3 | 2.5 |
11th grade | −0.19 (0.37) | 0.4 | 0.8 | 1.7 |
Socioeconomic status (ref high) | ||||
Medium | −0.13 (0.26) | 0.5 | 0.9 | 1.5 |
Low | −0.52 (0.35) | 0.3 | 0.6 | 1.2 |
Family constellation (ref both parents) | ||||
Single parent | 0.40 (0.28) | 0.9 | 1.5 | 2.6 |
Patchwork | 0.60 (0.32) | 1.0 | 1.8 | 3.4 |
Urban place of residence (ref rural) | 0.01 (0.22) | 0.7 | 1.0 | 1.6 |
Migration background (ref no) | −0.24 (0.27) | 0.5 | 0.8 | 1.4 |
Impact of headache on education
No headache (n = 824) | UdH (n = 884) | All migraine (n = 821) | All TTH (n = 731) | H15+ (n = 101) | Test statistic, p-valuef | |
---|---|---|---|---|---|---|
Headache burden (reported at least once in previous 4 weeks) (% of participants) | ||||||
Headache-attributed lost time: | ||||||
Missed whole school day | – | 11.0%a | 20.5%b | 11.3%a | 31.3%c | Chi2 = 47.3, p < 0.001 |
Left school early | – | 7.6%a | 15.2%b | 9.0%a | 24.2%c | Chi2 = 35.6, p < 0.001 |
Missed other activities | – | 26.8%a | 57.3%b | 34.5%c | 60.2%b | Chi2 = 141.6, p < 0.001 |
School performance (mean, SD)e | 2.1 (0.8)a, b | 2.1 (0.8)a | 2.3 (0.8)b | 2.2 (0.8)a, b | 2.3 (0.90)b | F = 6.7, p < 0.001 |
Acute medication use in previous 4 weeks | ||||||
Participants (%) | – | 28.5a | 58.7b | 43.9c | 67.3b | Chi2 = 128.9, p < 0.001 |
Number of days (mean, SD) | – | 0.8 (2.5)a | 1.8 (2.6)b | 1.0 (1.7)a | 6.5 (7.6)c | F = 121.4, p < 0.001 |
Health-related quality of life (HrQoL) | ||||||
Overall HrQoL | 52.9 (10.8)a | 53.9 (9.5)a | 47.5 (11.2)b | 50.6 (10.4)c | 43.1 (11.9)d | F = 56.3, p < 0.001 |
Self-perception | 51.0 (9.7)a | 50.9 (9.2)a | 46.4 (10.0)b | 48.2 (9.9)b | 42.9 (10.8)c | F = 42.3, p < 0.001 |
Parent-relation and home life | 53.9 (9.2)a | 53.6 (8.7)a | 50.3 (11.1)b | 51.9 (9.7)a, b | 44.8 (13.9)c | F = 31.6, p < 0.001 |
Social support and peers | 52.6 (9.4)a | 53.1 (8.7)a | 51.6 (9.8)a | 52.1 (8.8)a | 49.6 (13.2)b | F = 4.8, p = 0.001 |
School environment | 52.7 (10.5)a, c | 53.4 (8.8)a | 48.4 (10.1)b | 50.9 (9.3)c | 45.6 (12.6)d | F = 39.5, p < 0.001 |
Bullying | 50.7 (10.6)a | 51.9 (8.9)a | 50.4 (10.2)a | 50.7 (9.7)a | 47.3 (14.3)b | F = 6.4, p < 0.001 |