Frequent or severe headaches in childhood are associated with notable pain, mental health issues and functional limitations, according to findings published in the medical journal Pediatrics.

“Headaches are common among children and adolescents, particularly migraine and tension-type headaches,” Dr. Tara W. Strine and colleagues from the Centers for Disease Control and Prevention, Atlanta, write. “They contribute to missed school days, affect children’s peer and family relationships, and significantly impact children’s quality of life, often times into adulthood.”

The researchers evaluated 9,264 children between the ages of 4 and 17 years who were part of the National Health Interview Survey. They based their study on responses to the Strengths and Difficulties Questionnaire.

They found that about 6.7 percent of the children experienced frequent or severe headaches during the previous 12 months. These children tended to be older, white, non-Hispanic and living in or near poverty.

Compared with children without headaches, children with headaches were 3.5 times more likely to have a high level of emotional symptoms, 2.5 more likely to have conduct problems, 2.6 times more likely to have symptoms of hyperactivity or inattention and 1.7 times more likely to have peer problems.

High levels of impairments were 2.7 times more frequent in children with headaches, which suggests potential mental health issues. These children were also 2.9 times more likely than children without headaches to be upset or distressed by their difficulties and to have these difficulties interfere with their home life, friendships, classroom learning, and leisure activities, Strine’s team notes.

Overall, 82.2 percent of children with headaches and 77.6 percent of those without had visited a general physician in the previous 12 months. Children with headaches were also significantly more likely to have visited a mental health professional (17.9 percent versus 5.7 percent) or a general physician (9.9 percent versus 3.9 percent) in the previous year because of emotional or behavioral problems.

The authors note that 5.6 percent of the children with headaches and 1.9 percent of those without headaches were currently receiving special education services for emotional or behavioral problems.

“Given the bidirectional relationship between mental health and headaches, both general doctors and mental health professionals should play an integral role in the care of these children,” the authors conclude.

SOURCE: Pediatrics, May 2006.