Highlights
- •The literature regarding risk and prognostic factors for headaches was reviewed.
- •There is still limited knowledge and poor quality of evidence.
- •Female sex is a probable risk factor for onset of headaches.
- •Comorbid anxiety/depression is a probable prognostic factor for persistence of headaches.
- •Further research is needed.
Abstract
Little is known about childhood and adolescent risk and prognostic factors for recurrent
headaches. This systematic review 1) examined longitudinal evidence about factors
associated with onset and course of recurrent headaches in childhood or adolescence,
using meta-analysis where possible, and 2) evaluated the quality of this evidence
using a modified Grading of Recommendations Assessment, Development and Evaluation
framework. Through searching electronic databases, reference lists of included studies,
and an electronic mail list we identified and included 23 articles reporting 19 cohorts.
From the included studies we explored 27 risk factors for recurrent headaches, 27
prognostic factors for persistence of recurrent headaches, and 6 prognostic factors
for presence of headache-related disability. The quality of evidence for most associations
is low or very low. There is moderate-quality evidence that women are at risk of developing
recurrent headaches and of headaches persisting. There is high-quality evidence suggesting
that children with negative emotional states manifested through anxiety, depression,
or mental distress are not at risk of developing headache, but moderate-quality evidence
suggests that the presence of comorbid negative emotional states in children with
headaches is associated with increased risk of headache persistence. Because of the
small number of studies, further investigation is needed to increase confidence in
existing evidence and to explore new risk and prognostic factors.
Perspective
This is a review of the evidence about childhood and adolescent risk and prognostic
factors for the onset of recurrent headaches and their course. Understanding these
factors can help identify childrens' risk and may suggest ways to reduce this risk.
Key words
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Article info
Publication history
Published online: April 18, 2016
Footnotes
This research is funded by the Canadian Institutes of Health Research (grant 226950). P.J.M.'s research is supported by a Canada Research Chair. J.H. holds a Professorship in Epidemiology supported by Dalhousie University and the Canadian Chiropractic Research Foundation.
The authors have no conflicts of interest to declare.
Supplementary data accompanying this article are available online at www.jpain.org and www.sciencedirect.com.
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© 2016 by the American Pain Society
