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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. [ABSTRACT FROM AUTHOR]

Introduction and Objective. Migraine is the most common acute and recurrent headache in children. The pain is the result of stimulation of meningeal nociceptors. There may be a genetic predisposition to generalized neuronal hyperexcitability. Aura is caused by the cortical spreading depression (CSD). Migraines hamper daily functioning and cause adverse effects in future adult life. This review aims to introduce the most common forms and present their diagnosis and treatment methods. Review Methods. The following electronic databases were searched: Pubmed, Google Scholar using the keywords 'childhood migraine disorder', 'paediatric migraine', 'migraine in children'. Articles in English were included. Brief description of the state of knowledge. The review shows both the diagnostic modalities of migraines and the latest methods of treating and preventing migraines from developing. Summary. In the diagnosis of migraine in paediatric patients, particular importance is attached to a thorough clinical history. Paediatric patients suffering from migraine have a reduced density of grey matter in the frontal cortex. In the therapeutic process a multi-media approach, including lifestyle changes, psychoeducation and psychotherapy and pharmacotherapy, are important. Conclusions. There is a good response to OCT analgesics in children and adolescents. There are reports in the literature that migraine occurring in children becomes a risk factor for migraines in adults. Migraines in children represent a difficult disease entity, both diagnostically and therapeutically. To-date, no significant changes have been demonstrated on imaging studies in children and the symptoms themselves may be uncharacteristic. Further research is needed to consider and implement the use of new drugs. [ABSTRACT FROM AUTHOR]

Introduction: We wanted to evaluate how the COVID-19 pandemic and consequent isolation have influenced some psychological characteristics according to the model of the Big Five theory in a group of adolescents suffering from chronic diseases such as headache. Material and methods: Before and after the lockdown for the COVID-19 pandemic, we administered the Big Five Inventory (BFI) to a group of adolescents suffering from headache. We took into account the presence of protective factors and risk factors, such as psychiatric comorbidity, friendships, relation with parents, perception of school difficulties and bullying, through a structured interview. We used the Wilcoxon signed-rank test to evaluate the differences for factors of the Big Five model between the two periods. Results: Fifteen patients (12 females and 3 males), with a mean age of 16 years (max. 18 years, min. 13 years), agreed to repeat the evaluation after one year; of these, 7 suffered from tension-type headache, 5 from migraines with aura and 3 females from somatization headache. There was a significant increase in the levels of conscientiousness after the lockdown. Conclusions: Our study demonstrated an unexpected improvement in a personality trait considered positive, during a period of high traumatic value. We hypothesize that adolescents suffering from chronic headaches may have peculiar personal characteristics, and that these may be susceptible to some environmental and relational factors. [ABSTRACT FROM AUTHOR]

The objective of this study is to examine the association between headache and mental disorders in a nationally representative sample of American youth. We used the National Comorbidity Survey–Adolescent Supplement to assess sex-specific prevalence of lifetime migraine and non-migraine headache using modified International Headache Society criteria and examine associations between headache subtypes and DSM-IV mental disorders. Adolescent report (n = 10,123) was used to identify headache subtypes and anxiety, mood, eating, and substance use disorders. ADHD and behavior disorder were based on parent report (n = 6483). Multivariate logistic regression analyses controlling for key demographic characteristics were used to examine associations between headache and mental disorders. Headache was endorsed by 26.9% (SE = 0.7) of the total sample and was more prevalent among females. Youth with headache were more than twice as likely (OR 2.74, 95% CI 1.94–3.83) to meet criteria for a DSM-IV disorder. Migraine, particularly with aura, was associated with depression and anxiety (adjusted OR 1.90–2.90) and with multiple classes of disorders. Adolescent headache, particularly migraine, is associated with anxiety, mood, and behavior disorders in a nationally representative sample of US youth. Headache is highly prevalent among youth with mental disorders, and youth with headache should be assessed for comorbid depression and anxiety that may influence treatment, severity, and course of both headache and mental disorders. [ABSTRACT FROM AUTHOR]

This study examined parenting factors associated with children's self-regulation and physician-rated treatment adherence using a self-determination theory framework in pediatric chronic headache. Participants were 58 children and adolescents (aged 10–17 years), who underwent initial and follow-up multidisciplinary evaluation at a headache clinic, and their mothers. Regression analyses showed that higher maternal autonomy support and structure were significantly related to children's lower treatment-related reactance and higher adherence. Maternal controllingness had associations in the opposite directions. Children's fear of pain was related to maternal controllingness. Results suggest the importance of parents' provision of clear expectations and engaging children in treatment problem-solving and decision-making. [ABSTRACT FROM AUTHOR]

Background: A scarcity of studies on the role of resilience resources (RRs) and vulnerability risk (VR) in children and adolescents with primary headache hampers the development of a risk‐resilience model for pediatric headaches. Objective: To examine the extent to which headache frequency and diagnosis are associated with RRs and VR and explore possible predictors of low RRs and high VR in a cross‐sectional population‐based study in adolescents. Methods: This is a cross‐sectional population study conducted in a small city in Brazil (Delfinópolis). Consents and analyzable data were obtained from 339/378 adolescents (89.7%). RRs and VR were assessed using the validated Brazilian version of the Resiliency Scales for Children and Adolescents, completed by the adolescents. Parents filled a structured questionnaire assessing sociodemographic and headache characteristics, as well as the Brazilian‐validated version of the Strengths and Difficulties Questionnaire added to the impact supplement to evaluate the adolescent's psychosocial adjustment skills. Teachers completed a structured questionnaire about the students' school performance. Results: A higher frequency of headache was associated with lower RRs (F3,335 = 2.99, p = 0.031) and higher VR (F3,335 = 4.05, p = 0.007). Headache diagnosis did not significantly influence the risk of having lower RRs or higher VR. In the exploratory analyses, females (OR 3.07; 95% CI: 1.16–9.3) and individuals with psychosocial adjustment problems (OR 7.5; 95% CI: 2.51–22.4) were predictors of low RRs, and prenatal exposure to tobacco (OR 5.6; 95% CI: 1.57–20.9) was a predictor of high VR in adolescents with primary headache. Conclusions: The risk of low RRs and high VR was associated with a higher headache frequency, but not with headache diagnosis. These findings may contribute to the development of a risk‐resilience model of headaches in the pediatric population and help identify novel targets and develop effective resources for successful interventions. [ABSTRACT FROM AUTHOR]

Context: Recurrent headaches significantly affect health-related quality of life (HRQOL) in adults; the impact of headache on HRQOL among adolescents is unknown, and the psychometric properties of headache-specific outcomes instruments have not been adequately studied in this population. Objective: To evaluate the psychometric properties of the Headache Impact Test (HIT-6) and Pediatric Migraine Disability Assessment (PedMIDAS) in healthy adolescent athletes. Design: Descriptive survey. Setting: High school athletic training facilities during the fall sports season. Participants: 177 high school athletes (89 males and 88 females). Interventions: A survey consisting of a demographic and concussion-history questionnaire, a graded symptom scale, the HIT-6, and the PedMIDAS. Internal consistency (α), test-retest reliability (rs), Bland-Altman analyses, and the Mann-Whitney U test were used to evaluate psychometric properties and age and gender differences. Main Outcome Measures: The HIT-6 and PedMIDAS item and total scores. Results: Test-retest reliability for the HIT-6 total score was rs = .72, and reliability of individual items ranged from rs = .52 to .67. The test-retest reliability for the PedMIDAS total score was rs = .61, and reliability of individual items ranged from rs = .23 to .62. Both scales demonstrated acceptable internal consistency: HIT-6 α = .89-.90 and PedMIDAS α = .71-.75. Conclusions: The authors found moderate test-retest reliability for the HIT-6 and the PedMIDAS in a healthy adolescent athlete population. Research on the applicability and utility of the HIT-6 and PedMIDAS in concussed adolescents is warranted. [ABSTRACT FROM AUTHOR]

Aims: To examine the influence of psychosocial functioning and dental factors in adolescents with temporomandibular disorders (TMD) versus healthy subjects. Methods: The TMD sample comprised 63 patients (21 boys and 42 girls, 33% and 67%, respectively, with a mean age of 14.9 years; range 12 to 18 years) and was compared with 64 healthy control subjects (17 boys and 47 girls, 27% and 73%, respectively, with a mean age of 14.8 years). Subjects in the TMD group had to report pain once a week or more and to have a TMD pain diagnosis according to the Research Diagnostic Criteria for TMD. Participants were clinically examined and filled out a questionnaire in which self-reported psychosocial functioning was assessed on standardized measures, including the Youth Self-Report (YSR), somatic complaints, and stress. Results: No significant differences were found in dental factors among adolescents in the TMD group compared with those in the control group. Multiple pains in the body and fatigue were significantly more common in the TMD group compared with the control group. Adolescents with TMD also reported significantly higher levels of stress, somatic complaints, and aggressive behavior than their counterparts in the control group. In particular, young adolescents with TMD reported high levels of psychosocial problems. Conclusion: In adolescents with TMD, psychosocial factors such as increased levels of stress, somatic complaints, and emotional problems seem to play a more prominent role than dental factors. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prevalence and characteristics of headache and its relationship with comorbidities and lifestyle in a teenage population.Methods: This is a cross-sectional study. Data was collected from students aged 12-18 years from six different schools in Catalonia, Spain. They completed an anonymous questionnaire with demographic, lifestyle, medical data, presence of recurrent headaches and its features, and completed the Strengths and Difficulties Questionnaire. We defined probable migraine if headache presented ≥ 3 ICHD-3 beta criteria for migraine. An analysis was performed to evaluate headache characteristics and compare lifestyles between those with or without headache.Results: 1619 out of 1873 students completed the survey (response rate 86.4%). From these, 30.5% suffered from recurrent headache and 11.3% had migraine features; 32.9% of adolescents with headache had at least one episode per week and 44.1% showed some degree of headache-related disability measured by the PedMIDAS scale. In a univariate analysis, headache was significantly more frequent in girls (35.1% vs. 25.5%, p < 0.001), teenagers with poor sleeping habits (36.6% vs. 27.6%, p < 0.001), lower physical activity ( p = 0.002), those who did not have breakfast (37.3 vs. 28.4%, p = 0.001), smokers (10.5% vs. 4.9%, p < 0.001) and caffeine overusers (30.9% vs. 24.7%, p = 0.009). Comorbidities significantly associated with headache were: allergies (38.8% vs. 29.3%, p = 0.007), other chronic pain disorders (44.7% vs. 27.6% p < 0.001), mental health problems (53.2% vs. 29.0%, p < 0.001) and worse SDQ scores ( p < 0.001).Conclusions: Headache is a common health problem among adolescents which impacts their quality of life. Headache is associated with presence of "unhealthy lifestyle" and other medical comorbidities. Educational initiatives should be started. [ABSTRACT FROM AUTHOR]

The article presents the discussion on recent advances in pediatric headache. Topics include highlighting exciting research developments and useful reviews within the field of pediatric headache medicine; and adolescents' increasing the use of electronics close to bedtime, later sleep and wake times, and increasing overall sleep duration.

Background Fifty-three percent of adolescent girls report headaches at the onset of menses, suggesting fluctuations of ovarian hormones trigger migraine during puberty. Aims To determine if urinary metabolites of estrogen and progesterone are associated with days of headache onset (HO) or severity in girls with migraine. Methods This was a pilot study and included 34 girls with migraine balanced across three age strata (pre-pubertal (8-11), pubertal (12-15), and post-pubertal (16-17) years of age). They collected daily urine samples and recorded the occurrence and severity of headache in a daily diary. Urine samples were assayed for estrone glucuronide (E1G) and pregnandiol glucuronide (PdG) and the daily change was calculated (ΔE1G, ΔPdG). Pubertal development was assessed by age, pubertal development score (PDS), and menstrual cycle variance. The primary outcome measures were HO days and headache severity. Generalized linear mixed models were used, and included the hormonal variables and three different representations of pubertal development as covariates. Results Models of HO days demonstrate a significant age*PdG interaction (OR 0.85 [95% CI 0.75, 0.97]) for a 1 standard deviation increase in PdG and three-year increase in age. A separate model showed a significant PDS*PdG interaction (OR -0.85 [95% CI; 0.76, 0.95]). ΔPDG was associated with headache severity in unadjusted models ( p < 0.017). Conclusion Age and pubertal development could moderate the effect of ovarian hormones on days of headache onset in girls with migraine. [ABSTRACT FROM AUTHOR]

There are few literature evidences about the intellectual profile of adolescents with headache and no study has used the fourth edition of the Wechsler Intelligence Scale for Children (WISC-IV) in patients with a diagnosis of headache according to the ICHD-III-beta. We recruited 30 patients (age 11-14 years; male:female = 1:2) seen for headache in a tertiary center in Northern Italy and 30 healthy controls matched for age and sex, recruited in a public school from the same geographic area. The diagnosis of headache was done according to the ICHD-III criteria (beta version): the case group was composed of 16 patients with migraine and 14 with tension-type headache. Cognitive functioning was assessed using the WISC-IV. Recruited patients with idiopathic headache diagnosis had on average a cognitive function within the normal range. We found no statistically significant differences in the total Intellective Quotient comparing patients with headache and controls; the Working Memory Index was, however, lower in patients with headache (p = 0.012), and in particular, we found a lower Digit Span (p < 0.001). We also found a borderline statistical difference (p = 0.051) between case and controls Verbal Comprehension Index (CVI), which was due to a lower score in the Similarities subtest (p < 0.001). Our results suggest that, although within normal limits, cognitive functioning of adolescents with headache differs from that of healthy peers regarding memory and verbal skills. The Working Memory Index is related to the subject's ability to store new information and keep them in short-term memory, to maintain focused attention and to manipulate them to find solutions. The difference in Similarities is also important because it provides a measure of the level of verbal reasoning and concept formation; it is also a measure of verbal abstract thinking skills relevant for language development, lexical knowledge, auditory comprehension, memory, and ability to discriminate between essential and non-essential characteristics. Our data, in keep with previous findings, suggest the need for further researches to better understand the pathogenesis of these difficulties and obtain ideas for an adequate rehabilitative treatment. [ABSTRACT FROM AUTHOR]

Background: Headache is one of the most common complaints in children and adolescents and comorbidity rates are very high and the major associated diseases are depression, anxiety, atopic disorders, sleep, and behavioral disorders. In recent years, it has been highlighted that difficulties regulating emotions such as alexithymia have also been associated with diagnosis of somatization. Methods: We carried out a mini review analyzing the relation between alexithymia and primary headache (e.g., migraine and tension type headache) in children and adolescents by synthesizing the relevant studies in the literature on PubMed, PsycINFO, and Google Scholar. Search terms were “alexithymia” combined with the “primary headache,” “migraine,” “tension type headache,” “children,” and “adolescents.” Results: All analyzed studies found higher levels of alexithymia in children and adolescents with headache than control groups but there are different opinions about the relationship between headache and alexithymia. For example, some studies suggest that the association between headache and alexithymia in children may be due to an incomplete development of emotive competency or a general immature cognitive development, instead other studies found a correlation between headache symptoms, insecure attachment, and alexithymia. There seems to be also differences between children with migraine compared to those with tension type headache (TTH). Conclusion: There are some studies on adults suffering from headache or migraine and alexithymia, but there is only a moderate amount of research on pediatric age with different opinions and theories about this relationship. Further studies on children and adolescents are necessary to effectively understand this relationship and to help children to reduce headache and improve emotional consciousness. [ABSTRACT FROM AUTHOR]

Anxiety disorders and headache are both among the most prevalent disorders among adolescents. Although cognitive behavioral therapy (CBT) has proved its efficacy with each of these disorders individually, there are several barriers to its utilization, including cost, gaps in knowledge about treatment delivery and modes, and its utility with comorbid disorders. The current study examined the comparative efficacy of a 12 week TCBT Group treatment ( n = 32) versus treatment as usual group ( n = 31) (TAU) in adolescents with anxiety disorders and headache in a north Indian hospital based setting. Results from 63 adolescents suggested while both conditions improved significantly on the Headache Impact Test and Children’s Global Assessment Scale, those receiving TCBT showed significantly greater improvement than those in the TAU condition. Participants receiving TCBT, but not those in the TAU condition, showed significant improvement on the State Trait Anxiety Inventory. The study provides evidence supporting the efficacy of TCBT in adolescents with anxiety disorders and headache. Further, group TCBT has the benefits of easy dissemination and increased access to evidence-based treatment, thus, lowering costs and therapist time. [ABSTRACT FROM AUTHOR]

Headache is a frequent neurological symptom in children and adolescents. Recurrent headaches have a significant disabling effect, with consequences including school absenteeism, decreased participation in extracurricular activities, and poor academic performance, and are a risk factor for further chronic headaches and other pain syndromes that merit increased attention. The most common types of primary headache in children and adolescents are migraine and tension-type headache (TTH). In a recent survey of South Korean school students, 29.1% of schoolchildren reported having recurrent headaches. TTH was more frequent than recurrent migraine headaches (13.7% vs. 8.7%), and the frequency of migraine and TTH increased with age. The prevalence rate of TTH in urban areas was higher than in suburban and rural areas. A trend was found for more severe disabilities to occur in older children with headache. Children and adolescents with migraine had the most severe headache-related disabilities. The predictors of headache-related disability were found to be migraine, severe intensity of the headache, frequent headache, and a longer duration of symptoms before presentation. Children and adolescents with recurrent or significant headaches should be diagnosed and treated promptly to reduce headache-related disability and to improve their quality of life. [ABSTRACT FROM AUTHOR]

Objective The objective of this article is to investigate whether excessive screen time exposure is associated with non-migraine headache and migraine in young adults. Background Increased levels of television time have been associated with increased risk of headache. However, time spent using newer electronic devices with a screen (smartphone, tablet) has not been examined yet. Methods We conducted a cross-sectional study among 4927 participants of the French i-Share cohort. Demographic characteristics, screen time exposure (computers, tablets, smartphones and television) as well as headache/migraine symptoms were recorded in a standardized questionnaire. Multinomial logistic regression models were used to evaluate the association between screen time exposure and headache status. Results Participants had a mean age of 20.8 years and 75.5% were female. The multivariable model showed that students in the highest screen time exposure quintile had an increased risk for migraine. The odds ratio (OR) (95% confidence interval (CI)) was 1.37 (1.14 to 1.66) for migraine when compared with students without headache and with low screen time exposure. This association was somewhat stronger for migraine without aura (OR = 1.50, 95% CI 1.19 to 1.89). We found no significant association between screen time exposure and non-migraine headache. Conclusion High levels of screen time exposure are associated with migraine in young adults. No significant association was found with non-migraine headache. [ABSTRACT FROM AUTHOR]

Headaches are very common in children and adolescents. Headaches occur, on average, in 53% of children and adolescents. Most headaches are classified as migraines, tension headaches, or mixed headache syndrome. Headaches may be either acute or chronic and may be either progressive or non-progressive. Many headaches in children and adolescents are amenable to lifestyle changes and relaxation techniques. Medical management in conjunction with complimentary and alternative therapies often provides the best results for headache management. [ABSTRACT FROM AUTHOR]

The frequency and significance of headache in children and adolescent has been drawing more attention nowadays. Similarly, growing body of data is being collected on the quality of life of headache in children and adolescent to which increased attention is paid. Compared with other chronic disorders, headache in children has more negative effect on school performance, as well as emotional status. As for school children, it is reported that these children could not go to school on a regular basis, they do less performance and their careers are negatively affected on the long-term. Accompanying symptoms such as depression, somatization, anxiety also impairs the quality of life. Early identification and treatment of headache will not only improve a health condition, but also will provide advancement in academic and social area as well as psychological development for children with headache. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the prevalence of headache in adolescents and its association with excessive use of electronic devices and games. The sample comprised 954 adolescents of both sexes (14 to 19 years) who answered a questionnaire about use of computers and electronic games, presence of headache and physical activity. The binary and multinomial logistic regression, with significance level of 5% was used for inferential analysis. The prevalence of headache was 80.6%. The excessive use of electronics devices proved to be a risk factor (OR = 1.21) for headache. Subjects aged between 14 and 16 years were less likely to report headache (OR = 0.64). Regarding classification, 17.9% of adolescents had tension-type headache, 19.3% had migraine and 43.4% other types of headache. The adolescents aged form 14 to 16 years had lower chance (OR ≤ 0.68) to report the tension-type headache and other types of headache. The excessive use of digital equipment, electronic games and attending the third year of high school proved to be risk factors for migraine-type development (OR ≥ 1.84). There was a high prevalence of headache in adolescents and high-time use of electronic devices. We observed an association between excessive use of electronic devices and the presence of headache, and this habit is considered a risk factor, especially for the development of migraine-type. [ABSTRACT FROM AUTHOR]

Objective: The current study provides the first measure of pain-related fear for pediatric headache patients.Methods: From a large pediatric headache clinic, a cross-sectional cohort of 206 children and adolescents completedmeasures of pain-related fear, anxiety sensitivity, catastrophizing, pain acceptance, functional disability, and schoolfunctioning.Results: The two-factor solution of the Fear of Pain Questionnaire (FOPQ) was confirmed from the originally derivedstructure with pediatric headache patients. Simultaneously regressing FOPQ subscales fear of pain and activity avoidanceon theorized construct validity measures demonstrated that fear of pain was more closely linked with anxiety sensitivityand pain catastrophizing while activity avoidance had a strong negative association with pain acceptance (activity engagementand pain willingness). Pain-related fear was not significantly associated with pain level. After controlling for demographicfactors and pain, fear of pain and activity avoidance accounted for an additional 26% of the variance in functionaldisability and school functioning outcomes, with activity avoidance accounting for much of this relationship.Conclusions: Although typically considered an influential construct among musculoskeletal patients, pain-related fear isalso an important factor influencing functioning among pediatric headache patients, with the dimension of activityavoidance particularly salient. [ABSTRACT FROM AUTHOR]

There are only a handful of drugs that have been submitted for and received an indication for the preventative treatment of migraine by the US Food and Drug Administration, as well as international governmental regulatory agencies. However, there are a wide variety of agents that are used for this indication with different levels of evidence for efficacy and tolerability. Several guidelines have been published in recent years examining the evidence-based medicine of migraine preventative therapy and these provide guidance especially for the primary care clinician, but also for neurologists whose primary focus is not headache medicine. Some of the therapies are used in children and adolescents while others are used more commonly in adults. In the adult population, an evolutive state of migraine is more commonly seen than in young persons, that is chronic migraine. There is a paucity of evidence for medications for this stage of migraine but there is a single agent that is approved for this use but not for use in the treatment of episodic migraine. There have been few advances in the field of migraine-preventative medications in recent years but potential novel approaches are in development. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present analysis is to confirm or refute the association of neck pain to migraine or tension-type headache and to assess whether this association is independent of other risk factors for headache. Methods: Secondary school students were invited to complete a questionnaire on headache and lifestyle factors in a cross-sectional study. Neck pain was assessed via (a) a screening question concerning neck pain and (b) denoting affected areas in schematic drawings of the human body. Results: Absolute increment in prevalence of headache with pain in the shoulder-neck region was between 7.5% and 9.6%. Gender, grade, stress and lifestyle factors were assessed as potential confounding factors. Nearly all factors were associated with shoulder-neck pain and most with headache. After adjustment for confounders, the association of neck pain with headache was almost completely confined to migraine (OR 2.39; 95% CI 1.48-3.85) and migraine+tension-type headache (OR 2.12; 95% CI 1.50-2.99), whereas the association with isolated tension-type headache was negligible (OR 1.22, 95% CI 0.87-1.69). Conclusion: Neck pain is associated with migraine but not with tension-type headache. A possible link between migraine and neck pain may be the cervico-trigeminal convergence of neck and meningeal sensory afferents or a disturbed descending inhibition in migraine. [ABSTRACT FROM AUTHOR]

A 16-year old girl with a 6 year history of valproate (Depakine Chrono) therapy for absence type epilepsy and 5 days history of Biseptol (Trimethoprim/Sulphamethoxazole) treatment for urinary tract infection (E. coli >106) developed an itchy papular exanthema of the neckline area with subsequent merging and spreading to the lower parts of the body. On the 7th day of Biseptol treatment, the girl was extremely restless, confused and complained of body pain, mainly of the head and the skin. A qualitative consciousness disorder kept progressing. Positive irritation signs of the meninges were present and hemorrhagic purpura developed on the abdomen and legs. A neurological examination confirmed the meningeal syndrome with a finding of strikingly generalized entire body painfulness and muscle weakness mainly of the lower limbs. The cerebrospinal fluid analysis revealed lymphocytic pleocytosis (CSF-Protein 0.96 g/l, reference range <0.2; Leucocytes 44/3, reference range <3/3) compatible with the diagnosis of aseptic meningitis. Due to negative culture, serologi-cal and molecular investigations, dermatomyositis or Guillain-Barré syndrome were considered. However, the clinical course of the disease and the results of skin biopsy with the focal desquamation of the upper layer of the epidermis with discrete lymphoplasmocytic infiltrates surrounding the blood vessels and lymphocytes in the interstitium led to the final diagnoses of drug induced aseptic meningitis and toxic epidermal necrolysis. Both diseases represent a rare complication of the adverse effects of pharmacotherapy in childhood and should be considered within the scope of the differential diagnostics in a child with aseptic meningitis and skin symptoms of unknown origin. [ABSTRACT FROM AUTHOR]

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Background/Objective: Migraineurs have atypical pain processing, increased expectations for pain, and hypervigilance for pain. Recent studies identified correlations between brain structure and pain sensation in healthy adults. The objective of this study was to compare cortical thickness-to-pain threshold correlations in migraineurs to healthy controls. We hypothesized that migraineurs would have aberrant relationships between the anatomical neurocorrelates of pain processing and pain thresholds. Methods: Pain thresholds to cutaneously applied heat were determined for 31 adult migraineurs and 32 healthy controls. Cortical thickness was determined from magnetic resonance imaging T1-weighted sequences. Regional cortical thickness-to-pain threshold correlations were determined for migraineurs and controls separately using a general linear model whole brain vertex-wise analysis. A pain threshold-by-group interaction analysis was then conducted to estimate regions where migraineurs show alterations in the pain threshold-to-cortical thickness correlations relative to healthy controls. Results: Controls had negative correlations (p<0.01 uncorrected) between pain thresholds and cortical thickness in left posterior cingulate/precuneus, right superior temporal, right inferior parietal, and left inferior temporal regions, and a negative correlation (p<0.01 Monte Carlo corrected) with a left superior temporal/inferior parietal region. Migraineurs had positive correlations (p<0.01 uncorrected) between pain thresholds and cortical thickness in left superior temporal/inferior parietal, right precuneus, right superior temporal/inferior parietal, and left inferior parietal regions. Cortical thickness-to-pain threshold correlations differed between migraine and control groups (p<0.01 uncorrected) for right superior temporal/inferior parietal, right precentral, left posterior cingulate/precuneus, and right inferior parietal regions and (p<0.01 Monte Carlo corrected) for a left superior temporal/inferior parietal region. Conclusions: Unlike healthy control subjects who have a significant negative correlation between cortical thickness in a superior temporal/inferior parietal region with pain thresholds, migraineurs have a non-significant positive correlation between cortical thickness in a superior temporal/inferior parietal region with pain thresholds. Since this region participates in orienting and attention to painful stimuli, absence of the normal correlation might represent a migraineurs inability to inhibit pain sensation via shifting attention away from the painful stimulus. [ABSTRACT FROM AUTHOR]

Abstract: Background: The causes of persistent headache following concussion are poorly understood. The objective of this study is to explore analgesic overuse as a potential cause of chronic post-traumatic headache among adolescents referred to a headache clinic following concussion. Methods: A retrospective chart review was conducted of all adolescent concussion patients referred to our pediatric headache clinic over the 16-month period between August 1, 2011, and November 30, 2012. Those patients with chronic post-traumatic headaches of 3-12 months' duration who also met International Headache Society criteria for probable medication-overuse headache were identified. Demographic data, concussion symptoms, and headache features were characterized from the initial evaluation and from follow-up visits. Results: Of 104 adolescent concussion patients referred during the study period, 77 had chronic post-traumatic headache of 3-12 months' duration. Fifty-four of 77 (70.1%) met criteria for probable medication-overuse headache. Only simple analgesics were overused. Thirty-seven patients (68.5%) had resolution of headaches or improvements to preconcussion headache patterns after discontinuing analgesics; seven (13%) had no change in headaches or worsening of headaches after discontinuing analgesics and 10 (18.5%) did not discontinue analgesics or were lost to follow-up. Conclusion: Excessive use of analgesics postconcussion may contribute to chronic post-traumatic headaches in some adolescents. Management of patients with chronic post-traumatic headache should include analgesic detoxification when medication overuse is suspected. [Copyright &y& Elsevier]

Headaches are among the most common disorders of the nervous system. On a global level, it is estimated that the prevalence of headache disorder in adults is 47 %. A proper treatment of headaches requires training of health care personnel, careful diagnosis and recognition of the condition, appropriate treatment with cost-effective drugs, simple changements in lifestyle and patient education. Unfortunately, a large number of people suffering from headache disorders are not diagnosed and treated. The unsatisfied needs in migraine can be faced by involving the pharmacist in the management of the pathology. To really understand which are the activities and the potential of community pharmacies in the management of patients with headache or migraine we took into account studies conducted around the world during the last 5 years. Based on the data collected it is clear that the role of the community pharmacist may be crucial in managing patients with headache or migraine but only if he receives an adequate and continuous education both on the management of therapies and maintains a stable relationship with the medical doctor and/or patient. In Piedmont a specific study to identify migraine sufferers has involved the community pharmacies in the administration of a questionnaire, specially crafted by the Italian Headache Foundation (FICEF non-profit association). [ABSTRACT FROM AUTHOR]

Background: Headaches are often under-diagnosed in adolescents. The aim of this study was to examine the one-yearprevalence of primary headaches among high school students in the city of Zagreb, the capital of Croatia.Methods: This was a population-based, cross-sectional study. A total of 2350 questionnaires consisting of questions ondemographic data, the presence and clinical characteristics of headaches were distributed among students in eight highschools; 2057 (87.5%) questionnaires were eligible for analysis.Results: The mean age of the students was 17.2±1.2 years; 50.2% were female. The prevalence of recurrent headachewas 30.1% (620/2057), girls 35.1%, boys 25.2%. Among students with headache, 291 (46.9%) had migraine, and 329(53.1%) had tension-type headaches (TTHs). The mean frequency of headaches was 5.66 per month in girls and 4.42 inboys; mean duration of a headache attack was 8.94 hours in girls and 8.37 hours in boys (NS). Unilateral headache waspresent in 31.6%, throbbing quality in 22.6%, dull in 34.4% of students; 22.4% had severe intensity and 70.3% moderate.Nausea was present in 4.0% always and in 14.7% frequently (girls 18.8%), photophobia in 41.3%, phonophobia in 63.2%,osmophobia in 23.9% (NS among genders). Almost 30% of students were disabled and stayed at home, more frequentlyboys. Girls (33.4%) were more likely to take drugs for every attack; number per month was 3.7. The results of this studyshowed that the prevalence of migraine among adolescents in Croatia was 16.5% for girls and 11.8% for boys; theprevalence of TTH was 18.4% for girls and 13.4% for boys.Conclusions: The prevalence of self-reported headache among high school students in Zagreb is relatively high. Significantgender differences in frequency and clinical characteristics were observed. Primary headaches among adolescents are animportant public health problem and should receive more attention from school and health authorities. [ABSTRACT FROM AUTHOR]

Abstract: Background: Excessive gum-chewing is underreported as a headache precipitant in children and adolescents. We evaluated the influence of daily excessive gum-chewing in older children and teenagers with chronic headache, emphasizing the impact of habit discontinuation and its reintroduction. Methods: Patients with chronic headache and excessive gum-chewing were consecutively recruited and asked to fill questionnaire pertaining headache characteristics, potential triggers, family history of headaches, and gum-chewing habits. These individuals were classified into four groups depending on the number of daily hours of gum-chewing. All children discontinued chewing for 1 month, reintroduced the habit, and were reinterviewed after 2 to 4 weeks. Results: Thirty patients (25 girls) were recruited. Median age was 16 years. Most had migraine-like headaches. Following gum-chewing discontinuation, 26 reported significant improvement, including headache resolution in 19. All 20 patients reinstituting the habit reported symptom relapse within days. Duration of headache before discontinuation and the number of daily hours of chewing had no influence on the response to habit discontinuation. Conclusion: Excessive daily gum-chewing may be associated with chronic headache and should get more attention in the medical literature. Physician and patient awareness of this association could have a meaningful impact on the quality of life of children and adolescents with chronic headache who chew gum excessively. [Copyright &y& Elsevier]

Background: Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children. Objective: The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment. Methods: The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments. Results: Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders. Conclusion: The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research. [ABSTRACT FROM AUTHOR]

The article presents abstracts on yoga research including hospital-based yoga for stroke survivors at Greater Baltimore Medical Center (GBMC), yoga for people with rheumatoid arthritis and yoga for children and adolescents with recurrent headache.

Abstract: Objectives: Sleep bruxism (SB) frequently is associated with other sleep disorders and pain concerns. Our study assesses the efficacy of a mandibular advancement appliance (MAA) for SB management in adolescents reporting snoring and headache (HA). Methods: Sixteen adolescents (mean age, 14.9±0.5) reporting SB, HA (>1d/wk), or snoring underwent four ambulatory polysomnographies for baseline (BSL) and while wearing MAA during sleep. MAA was worn in three positions (free splints [FS], neutral position [NP], and advanced to 50% of maximum protrusion [A50]) for 1week each in random order (FS–NP–A50 or NP–A50–FS; titration order, NP–A50). Reports of HA were assessed with pain questionnaires. Results: Overall, sleep variables did not differ across the four nights. SB index decreased up to 60% with MAA in A50 (P =.004; analysis of variance). Snoring was measured as the percentage of sleep time spent snoring. The subgroup of snorers (n =8) showed significant improvement with MAA (−93%; P =.002). Initial HA intensity was reported at 42.7±5/100mm, showing a decreasing trend with MAA (−21% to −51%; P =.07). Conclusion: Short-term use of an MAA appears to reduce SB, snoring, and reports of HA. However, interactions between SB, breathing during sleep, and HA as well as the long-term effectiveness and safety of MAA in adolescents need further investigation. [Copyright &y& Elsevier]

Several dietary habits and lifestyles can be associated with different headache types or with their progression to chronic forms. Different population-based studies have tried to investigate this relationship with poor or contradictory results. We shortly reported the current knowledges available in literature in this regard, paying particular attention to the role that certain factors play in modifying frequency and intensity of headache in adults and in adolescents. Future studies are necessary to clarify the real weight which the different factors have in natural history and in clinic evolution of headache, especially in adolescence, but the already known data suggest an important modulating action. If they will be confirmed, these results will be likely to influence clinical practice as well to address educational programs in preadolescents and adolescents. [ABSTRACT FROM AUTHOR]

The article presents the study which examined the prevalence, characteristics and clinical correlates of transient visual disturbances (TVD) in adolescents with headaches. The study was part of the Taitung County Adolescent Headache Survey conducted in Taiwan. The study was authorized by the Kaohsiung Medical University Hospital's Institutional Review Board.

Objectives To analyze content and quality of headache, abdominal pain, and dysmenorrhoea websites, and to thematically analyze online pain forums. Methods Websites offering support, advice, or information regarding pain were explored. Websites were analyzed quantitatively using the Health-Related Website Evaluation Form and the DISCERN scale. Websites containing forum functions were thematically analysed assessing how the Internet is used for support and advice. Results 63 websites were included. Few websites scored in the upper quartiles of scores on the measures. 7 websites contained supportive posts, pertaining only to dysmenorrhoea. The ways users cope and the coping judgements of other forum users are presented thematically. 3 themes emerged: (1) passively engaged postings, (2) actively engaged postings, and (3) reactively engaged postings. Conclusions Internet pain resources are of low quality and questionable value in providing help to adolescents. Future research should explore how to improve quality. [ABSTRACT FROM AUTHOR]

The aim of this article is to assess the concordance between parent and adolescent headache ratings in a representative sample of 6483 US adolescents (aged 13-18 years). Headaches were assessed using modified criteria from the International Headache Society’s International Classification of Headache Disorders, Second Edition. Caregiver report was based on a self-administered questionnaire. Overall concordance between caregivers and adolescents on the presence or absence of headaches was quite low (κ = 0.39). Female caregivers were twice as likely as male caregivers to report headaches in their offspring. Positive endorsement of headaches in offspring by caregivers was associated with adolescent-reported chronic headaches, longer headache duration, and photophobia or phonophobia. These findings suggest that relying solely on parent report may result in an underestimate of the true prevalence of headaches in the general population. In addition, collecting information from both parents and adolescents could be critical to effective treatment and prevention of the severe consequences of migraine. [ABSTRACT FROM PUBLISHER]

Abstract: The aim of this study was to determine the prevalence of self-reported chronic idiopathic pain among adolescents in relation to age and gender, and to explore how pain interferes with daily activities. The study was performed in Nord-Trøndelag County, Norway in 2006–2008. All adolescents were invited to participate; the response rate was 78%. Participants completed a comprehensive questionnaire, including questions about pain and interference with everyday life. Chronic idiopathic pain was defined as pain at least once a week during the last 3months, not related to any known disease or injury. The final study population, with complete pain questionnaires, consisted of 7373 adolescents aged 13–18years. Chronic pain was reported by 44.4% of the participants, and 25.5% reported pain in at least 2 locations. Chronic idiopathic musculoskeletal pain was most prevalent (33.4%), and the neck/shoulder was most commonly affected. Musculoskeletal pain in 3 or more locations was reported by 8.5%. Pain almost daily was reported by 10.2%. More girls than boys reported pain. In girls, the prevalence of pain increased with age. A high number of pain-associated disabilities were reported, and 58.5% described difficulties doing daily activities in leisure time. Subjective disabilities were higher in girls, and increased with the frequency of pain and the number of pain locations, as shown by high disability in adolescents with musculoskeletal pain in 3 or more locations. Chronic idiopathic pain, especially multisite pain, is common among adolescents, and those suffering from it report a major impact on several areas of daily living. [Copyright &y& Elsevier]

In this article, the authors discuss the use of electronic diary (e-diary) recordings in assessment and understanding of headache trigggers, stressors, and behaviors of children and adolescents. The authors mention the potential of the assessment method using e-diaries in eliciting more reliable and accurate information on the prevalence of headache in children and adolescents. However, the authors state the need for evaluating the assessment method of headache occurrence using diary recordings.

Abstract: Objective: Earlier epidemiological studies have shown that headaches are frequent among adolescents, especially girls. In particular, recurrent primary headache disorders such as migraine and tension-type headaches are common complaints in this age group. Headaches are increasingly being recognized as a significant health problem in adolescents and can lead to significant disabilities by affecting their lives, their school performance and their social lives. The aim of this study was to compare the prevalence of primary headaches among adolescents aged 16–20 years in Norway in two periods. Very few replicate studies have re-evaluated the prevalence of primary headaches in this age range and it is uncertain whether the prevalence is increasing. Methods: Two cross-sectional, population-based studies were conducted in Norway from 1995 to 1997 (Young-HUNT 1) and from 1999 to 2001 (Young-HUNT 2). In Young-HUNT 1, 2594 adolescents in 2nd and 3rd grade in upper secondary school (aged 16–20 years) completed a comprehensive questionnaire including one question regarding headache during the last 12 months. In addition, 1730 of the students were interviewed about their headache complaints. In Young-HUNT 2, 2373 adolescents aged 16–20 years completed the same questionnaire and 1655 were interviewed in the same way as the earlier survey. The interviews were performed by trained nurses, and respondents were asked if they had experienced recurrent headache during the last year. If so, the headache was classified as migraine (MI), tension-type headache (TTH) or non-classifiable headache (NCH). Headache frequency during the past year was recorded according to the following categories: Less than 1 day per month (less than monthly), 1–3 days per month (monthly), 1–5 days per week (weekly), or more than 5 days per week (daily). Results: The participation rate was 88% in Young-HUNT 1 and 81% in Young-HUNT 2. The overall prevalence of having had headaches during the last 12 months did not change significantly (79.4% versus 77.5%; OR: 0.89, 95%CI: 0.79–1.02, p =0.09), whereas the prevalence of recurrent headaches increased from 30.3% in Young-HUNT 1 to 35.4% in Young-HUNT 2 (OR: 1.26, 95%CI: 1.09–1.46, p =0.002). The prevalence of tension-type headache changed significantly from 19.0% to 21.9% (OR: 1.20, 95%CI: 1.02–1.42, p =0.03). Also the prevalence of migraine tended to increase (7.5% versus 8.7%, OR: 1.18, 95%CI: 0.92–1.52, p =0.18). The overall frequency of recurrent headache changed towards more monthly and less weekly headache. Conclusions: This is the first large-scale population-based study among adolescents in Norway assessing changes in the prevalence of primary headaches over a four-year period of time. The overall prevalence of recurrent headaches increased significantly from Young-HUNT 1 to Young-HUNT 2. An increase was seen in all types of recurrent headaches and was significant for tension-type headache. Implications: Earlier follow-up studies have examined changes in prevalence of recurrent headaches in young age, but the results are diverging. Our findings support the impression that the prevalence of recurrent headache among adolescents is increasing, and underlines the need for prospective designed studies with emphasis on prognosis and etiological factors. [Copyright &y& Elsevier]

Objective. The relationship between recurrent headache and reduced psychological well-being among adolescents has been well documented. Evidence also suggests that headache is associated with greater impediment to successful goal pursuits, which in turn is related to reduced well-being. The aim of this study was to investigate both the independent and interactive effects of headache and self-regulatory processes on daily positive and negative affect. Design and methods. In order to be able to investigate both concurrent and prospective relationships a daily diary design was employed. Independent variables were headache occurrence, daily goal frustration, and strategies to cope with these setbacks. Dependent variables were daily negative and positive affect. Eighty-nine adolescents from the general population aged 13-21 completed an on-line diary for 3 weeks. Data were analysed using multi-level modelling. Results. Negative affect was related to same day headache occurrence, high daily goal frustration, rumination, catastrophizing, other blame, and low coping efficacy beliefs. Furthermore, in the context of headache, coping efficacy appears to buffer the effects of goal frustration on same day negative affect. Negative affect on the next day was predicted by high daily goal frustration, rumination, catastrophizing, and low coping efficacy. In contrast, positive affect was related to no same day headache occurrence; low daily goal frustration, and high acceptance, positive refocusing, and coping efficacy. Positive affect on the following day was related to low daily goal frustration, rumination, and high positive refocusing. Conclusions. Daily goal frustration and cognitive coping strategies may provide important targets for interventions aimed at adolescent with reduced well-being due to headache. [ABSTRACT FROM AUTHOR]

The aim of this study was to review systematically the prevalence of headache and migraine in children and adolescents and to study the influence of sex, age, and region of residence on the epidemiology. We systematically searched the literature in electronic databases to cover the period between 1 January 1990 and 31 December 2007. We assessed and included population-based studies on epidemiology of headache and migraine in children and adolescents if they fulfilled the following criteria: (1) reporting on unselected childhood population; (2) reliable methods of data collection using a questionnaire or face-to-face interviews; (3) using the International Headache Society's (IHS) criteria (1988 or 2004) for the diagnosis of migraine; and (4) provision of sufficient and explicit data for analysis. We used Excel, Stata, and Confidence Interval Analysis software. We identified and analysed 50 population-based studies reporting the prevalence of headache and/or migraine in children and adolescents (<20y). The estimated prevalence of headache over periods between 1 month and lifetime in children and adolescents is 58.4% (95% confidence interval [CI] 58.1-58.8). Females are more likely to have headache than males (odds ratio [OR] 1.53, 95% CI 1.48-1.6). The prevalence of migraine over periods between 6 months and lifetime is 7.7% (95% CI 7.6-7.8). Females are more likely than males to have migraine (OR 1.67, 95% CI 1.60-1.75). Regional differences in prevalence of migraine, though statistically significant, may not be of clinical significance. The change in the IHS's criteria for the diagnosis of migraine was not associated with any significant change in the prevalence of migraine. This study confirms the global high prevalence of headache and migraine in children and adolescents. Sex, age, and regional differences are evident. [ABSTRACT FROM AUTHOR]

Headache is a common problem among adolescents, and variations can be observed in headache types and characteristics. The present study aimed to reach 5562 Turkish children who were investigated six years previously in a school-based childhood headache project, and to evaluate their current headache status. Investigators interviewed the available students with structured questionnaires. New and old data were matched and analyzed. The present study included 1155 adolescents (mean age 15.2 ± 1.1 years), with 582 boys (50.4%) and 573 girls (49.6%). The prevalence of headache was 78.7% (tension-type headache [TTH] 57.5%, migraine 18.6%, unspecified 2.6%). The prevalence of headache was 45.2% six years previously. In the intervening six years, headache prevalence increased and the headache types changed significantly (Kappa: 0.04, p < .01). The most important variation during this time was the significant increase in TTH. Analgesic use was determined in 70.2% of adolescents with headache, with this ratio being higher in migraineurs. In conclusion, there were an increase in headache prevalence and a significant change in headache types over the previous six years. It can also be suggested that new country-based management strategies are required. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this study was to investigate the relationships between goal frustration, coping and well-being in the context of adolescent headache. Firstly, we investigated whether adolescents with weekly, monthly or no headache complaints differed with regard to the importance assigned to their personal goals, experience of goal frustration, coping with goal frustration and well-being. Secondly, the extent to which goal and coping factors contributed to well-being and whether this relationship differed according to the frequency of headache complaints was examined. For this purpose, 1202 adolescents aged 12–18 completed self-report questionnaires in schools. Adolescents were divided into three groups based on their experience of headache: no headache reported (38%); monthly headache (40%); weekly headache (18%). Results show that these groups did not differ with respect to the importance they attach to goals. They did, however, differ according to experience of goal frustration, use of strategies to cope with goal frustration and well-being, although effect sizes were small. After controlling for individual and headache characteristics, frustration of self acceptance and health goals, and the use of self blame, rumination and other blame were consistently related to lower well-being. Moreover, interactions with headache group indicated that for adolescents with weekly headache, greater frustration of school and self acceptance goals and a lower importance assigned to health goals was more detrimental to well-being than for those with no headache complaints. We conclude that frustration to goal pursuit and strategies for coping with this frustration are important factors in adolescent well-being and may offer important targets for intervention. [Copyright &y& Elsevier]

Here, we investigated the prevalence of headache among adults in Jordan. The study was conducted from January 2007 to November 2008. A sample of 4,836 participants were permitted to complete a self-conducted screening questionnaire. As much as 82.3% of participants complained from headache at least once per year. 36.1% were tension-type headache and 59% of the participants had other family members who suffered from headache. Headaches affected everyday activities in 51.6% of the participants; 82.7% of participants did not seek medical attention for their headaches. Among those who used analgesics (75.6%), acetaminophen was the most common (91.43%). In conclusion, headache and overuse of analgesics were prevalent in a significant part of the society. Thus, there is a need to educate the public to ensure safe practices and to make the use and selling of analgesics more stringent. [ABSTRACT FROM AUTHOR]

Background: Because the epidemiologic data available for adolescents from the developing world is scarce, the objective is to estimate the prevalence and severity of psychiatric disorders among Mexico City adolescents, the socio-demographic correlates associated with these disorders and service utilization patterns. Methods: This is a multistage probability survey of adolescents aged 12 to 17 residing in Mexico City. Participants were administered the computer-assisted adolescent version of the World Mental Health Composite International Diagnostic Interview by trained lay interviewers in their homes. The response rate was 71% ( n = 3005). Descriptive and logistic regression analyses were performed considering the multistage and weighted sample design of the survey. Results: One in every eleven adolescents has suffered a serious mental disorder, one in five a disorder of moderate severity and one in ten a mild disorder. The majority did not receive treatment. The anxiety disorders were the most prevalent but least severe disorders. The most severe disorders were more likely to receive treatment. The most consistent socio-demographic correlates of mental illness were sex, dropping out of school, and burden unusual at the adolescent stage, such as having had a child, being married or being employed. Parental education was associated with treatment utilization. Conclusions: These high prevalence estimates coupled with low service utilization rates suggest that a greater priority should be given to adolescent mental health in Mexico and to public health policy that both expands the availability of mental health services directed at the adolescent population and reduces barriers to the utilization of existing services. [ABSTRACT FROM AUTHOR]

Background.— The impact of perceived teacher unfairness on headache incidence has previously been insufficiently investigated. Objective.— The aims of the study are to analyze the prevalence of headache among Italian early adolescents as well as to examine the role of perceived teacher unfairness and classmate social support in predicting this health outcome. Methods.— Data were taken from the “Health Behaviour in School Aged Children,” a cross-sectional survey investigating health behaviors among early adolescents in selected European countries. Headache, perceived teacher unfairness, and classmate social support were measured through a self-administered questionnaire filled out by a representative sample of 4386 (48.4% males) Italian students (11, 13, and 15 years old). Covariates included demographic characteristics (age, gender) and socioeconomic status (parental educational attainment), and other confounding psychological factors (eg, family empowerment, bullying). Results.— Prevalence of frequent headaches (at least once a week) was about 40%. Girls were more likely to report frequent headaches compared with boys. Prevalence of frequent headaches increased with age. After adjusting for age and gender, teacher unfairness showed a significant association with frequent headache ( P < .001). This relationship remained significant even after additional adjustment for several psychosocial factors. Classmate social support seems to act as a protective factor, but not as a buffering mechanism against the negative effects of teacher unfairness. Conclusions.— Italian early adolescents show a quite high prevalence of frequent headache. Results show that characteristics of the school setting, such as teacher unfairness and classmate social support, can be significant predictors of frequent headache among early adolescents. Longitudinal research is needed to delineate causal relationships between school factors and recurrent headache. [ABSTRACT FROM AUTHOR]

The broad field of orofacial pain encompasses pain conditions affecting the head, face, neck and intraoral structures. Much has been written about headache specifically affecting adults, but little is known about the presentation of this problem in children. Dentists may be asked to participate in the differential diagnosis or management of headache in young patients. For their benefit, this article discusses the epidemiology, clinical presentation, diagnosis and treatment of headache in this population. An accurate history and careful examination can allow early diagnosis and the avoidance of unnecessary or inappropriate dental procedures. [ABSTRACT FROM AUTHOR]

Background.— While adult headache patients' satisfaction with treatments has been widely investigated, less attention has been paid to children and adolescent headache patients' opinions and their parents' views. Objective.— The aim of our follow-up survey was to analyze the outcomes of the Headache Centre's intervention and the evolution of headache according to patients until the age of 16 and their parents. Methods.— We studied all outpatients suffering from episodic primary headache according to International Classification of Headache Disorders 2nd edition criteria, seen for the first time in 2005-2006 at the Headache Centre of the University Hospital of Modena (Italy), and at least one of their parents. The duration of the follow-up ranged from 1 to 3 years. For the purpose of the study, a specific questionnaire was created and administered by a telephone interview. Results.— We enrolled 84 patients (38 females, 45%; 46 males, 55%; mean age ± SD: 12.9 ± 2.9 years) with primary headache: migraine without aura 66%, episodic tension-type headache 23%, migraine with aura 11%. At the follow-up, 70% of the patients reported that headache had improved; frequency had decreased significantly more than severity ( P = .000, Fisher's exact test), both in those who had followed a prophylactic treatment and in those who had not. A high percentage of the children and parents could precisely indicate trigger factors for headache: especially excessive worrying and studying. The patients reporting an improvement attributed it to pharmacological prophylactic treatment, but also to other factors: first of all, better school results and more happiness than before. Seventy-seven percent of the parents thought that the Headache Centre's intervention had helped them to better understand and manage their children's headache. Conclusions.— Children's and adolescents' headache has in most cases a favorable prognosis; the Headache Centre's intervention is considered effective by most parents. We must increase and focus therapeutic efforts addressed to the few patients with worsening headaches in spite of treatment, since these children's/adolescents' headache also is at risk to progress in the adult age. [ABSTRACT FROM AUTHOR]