The prevalence and impact of primary headaches in orphaned children: a cross-sectional, observational study in a boarding school

Abstract

The relationship between headache and stressful life events experienced in childhood has been found mostly associated with recurrent primary headaches and headache chronicity. We aimed to investigate the prevalence, clinical characteristics, daily life impact of migraine and tension-type headache in orphaned children with low income in a boarding school. Four hundred and fifteen permanent boarders aged 12-17 years were evaluated using the Structured Headache Questionnaire, the Pediatric Migraine Disability Assessment Scale (PedMIDAS), the Strength and Difficulties Questionnaire and Visual Analogue Scale (VAS). Prevalence of primary headache was 59.8%; 24.1% for migraine; 35.7% for tension-type headache; 4.1% for chronic migraine; and 2.4% for chronic tension-type headache. Prevalence of probable diagnoses was found to be higher in early ages; however, definite diagnoses became more common with age. Sex distribution was affected by age in migraineurs. The most distinctive features separating migraine were high frequency, pain severity, throbbing/pounding nature, photophobia, phonophobia, nausea, vomiting, and aggravated by physical activity. Prodromal symptoms and triggering factors were more closely associated with migraine. Sleep was the most common method to relieve of headache, taking medicines was preferred more commonly in migraineurs with a higher mean number of analgesics. Mean VAS, PedMIDAS, and total difficulty scores were higher in migraineurs, emotional problems were found increased in migraine. Headache is underestimated in pediatric population when probable diagnoses are not evaluated. The prevalence of primary headaches and the risk of chronic headaches are high in orphaned students, especially in older adolescent girls, and the effect of headache on daily life is evident.