The burden attributable to headache disorders in children and adolescents in Lithuania: estimates from a national schools-based study

The Journal of Headache and Pain

Nerija Vaičienė-Magistris¹  Diana Genc¹  Christian Wöber²  Timothy J. Steiner³  Apolinaras Zaborskis⁴  Tayyar Şaşmaz⁵  Aylin Yeniocak Tunç⁵  Çiçek Wöber-Bingöl⁶  Derya Uluduz⁷ 

[1] Department of Neurology, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania;Department of Neurology, Medical University of Vienna, Vienna, Austria;Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway;Division of Brain Sciences, Imperial College London, London, UK;Department of Preventive Medicine and Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania;Department of Public Health, Mersin University School of Medicine, Mersin, Turkey;Dr Gönül Bingöl-Dr Muammer Bingöl Çocuk ve Ergen Başağrısı Derneği – Society for Headache in Children and Adolescents, Suadiye, Istanbul, Turkey;Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey;

关键词: hild and adolescent headache;    Migraine;    Tension-type headache;    Medication-overuse headache;    Undifferentiated headache;    Epidemiology;    Burden of disease;    Schools-based study;    Lithuania;    Global campaign against headache;   

DOI  :  10.1186/s10194-021-01237-3

来源: Springer

【 摘 要 】

BackgroundWe recently showed headache to be common in children (aged 7–11 years) and adolescents (aged 12–17) in Lithuania. Here we provide evidence from the same study of the headache-attributable burden.MethodsFollowing the generic protocol for Lifting The Burden’s global schools-based study, this cross-sectional survey administered self-completed structured questionnaires to pupils within classes in 24 nationally representative schools selected from seven regions of the country. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH; defined as mild headache with usual duration < 1 h). Burden enquiry was conducted in multiple domains.ResultsQuestionnaires were completed by 2505 pupils (1382 children, 1123 adolescents; participating proportion 67.4%), of whom 1858 reported headache in the preceding year, with mean frequency (±SD) of 3.7 ± 4.5 days/4 weeks and mean duration of 1.6 ± 1.9 h. Mean proportion of time in ictal state, estimated from these, was 0.9% (migraine 1.5%, probable medication-overuse headache [pMOH] 10.9%). Mean intensity on a scale of 1–3 was 1.6 ± 0.6 (mild-to-moderate). Symptomatic medication was consumed on 1.5 ± 2.8 days/4 weeks. Lost school time was 0.5 ± 1.5 days/4 weeks (migraine 0.7 ± 1.5, pMOH 5.0 ± 7.8) based on recall, but about 50% higher for migraine according to actual absences recorded in association with reported headache on the preceding day. More days were reported with limited activity (overall 1.2 ± 2.4, migraine 1.5 ± 2.2, pMOH 8.4 ± 8.5) than lost from school. One in 30 parents (3.3%) missed work at least once in 4 weeks because of their son’s or daughter’s headache. Emotional impact and quality-of-life scores generally reflected other measures of burden, with pMOH causing greatest detriments, followed by migraine and tension-type headache, and UdH least. Burdens were greater in adolescents than children as UdH differentiated into adult headache types.ConclusionsHeadache in children and adolescents in Lithuania is mostly associated with modest symptom burden. However, the consequential burdens, in particular lost school days, are far from negligible for migraine (which is prevalent) and very heavy for pMOH (which, while uncommon in children, becomes four-fold more prevalent in adolescents). These findings are of importance to both health and educational policies in Lithuania.

【 授权许可】

CC BY