Abstract
BackgroundReliable information on headache characteristics, including frequency and intensity, headache-associated impairment, and use of analgesic medications, may depend on the assessment method used. This study analyzed the correlations between headache characteristics determined in structured interviews and those determined in prospective diary recordings kept by adolescents in the general population.MethodsIn this cross-sectional school-based study, a representative sample of 488 adolescents aged 12–18 years were interviewed about headaches experienced during the previous year. Headache diaries for a three-week period were kept by 393 participants: 244 girls (62 %) and 149 (38 %) boys.ResultsMost adolescents (88 %) who reported headaches during their interview also recorded headaches in their diary. In contrast, 51 % of those who reported being headache-free during the last year recorded headaches in their diary. In the interviews, frequent headaches (at least 50 % of days during the last year) were reported by 2.9 % of participants, while 25.5 % reported this headache frequency in their diary. Overall, the ratings of headache frequency were significantly higher in diaries than in interviews (p < 0.001). Significant but low correlations were observed between intensity levels reported retrospectively and prospectively (rho = 0.28; p < 0.001) and between average scores of headache-related impairment reported retrospectively and prospectively (rho = 0.35; p < 0.001). The use of medications by those who reported one or more current headache disorder during their interview was significantly lower in prospective recordings than in the retrospective interview estimates (p < 0.001).ConclusionsThere is inconsistency in the estimates of headache characteristics between retrospective reports and diary recordings. A comprehensive picture of headache complaints among adolescents may be better obtained through a combination of prospective diary recordings and interviews by school health and clinical services.
Highlights
Reliable information on headache characteristics, including frequency and intensity, headache-associated impairment, and use of analgesic medications, may depend on the assessment method used
A Dutch study with children and adolescents aged 9–16 years found that questionnaires overestimated headache intensity and duration when compared with diary recordings, whereas the estimates were equal for headache frequency [8]
More than half of those who did not report any headaches during their interview recorded a headache during the diary period, these headaches were of low intensity
Summary
Reliable information on headache characteristics, including frequency and intensity, headache-associated impairment, and use of analgesic medications, may depend on the assessment method used. A Dutch study with children and adolescents aged 9–16 years found that questionnaires overestimated headache intensity and duration when compared with diary recordings, whereas the estimates were equal for headache frequency [8]. A recent Swedish school-based study with adolescents aged 12–18 years reported that questionnaires overestimated headache intensity and underestimated headache frequency and duration when compared with diary recordings [7]. These earlier studies did not include all types of headache. The Dutch study only included school children who reported a headache frequency of at least once a week [8], and the Swedish study excluded adolescents who considered their headaches to be disease-related (approximately onethird of those screened) [7]
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