Prevalence and predictors of headaches in US adolescents

Objectives.-To examine the prevalence of headaches among US adolescents; to explore the differences in prevalence by sex, race, and age; and to test t he nature of the association between headaches: and depression, self-esteem , and insomnia. Methods.-This longitudinal study used a nationally representative sample of adolescents (n=6072) who were interviewed in 1995 (wave 1) and then interv iewed a year later in 1996 (wave 2). Path analyses were used to test for th e relationships among headaches, insomnia, depression, and self-esteem. Results.-More than 90% of subjects had experienced one or more headaches du ring the past 12 months. Of that 90%, about 30% reported recurrent headache s occurring weekly or more frequently. Girls tended to report more recurren t headaches (37.6%) than boys (21.3%). American Indians experienced the hig hest rate (35.6%) of recurrent headaches followed by white adolescents (32. 1%). Depression and low self-esteem in wave 1 were found to precede the hea daches in wave 2 in girls, but not in boys. No causal relationship was foun d between insomnia and headaches. Conclusions.-Headaches are prevalent among US adolescents, especially in gi rls and American Indians. This study suggests the existence of different pa ths involving different factors in headache-presenting behavior for boys an d girls. Further studies are needed to illustrate the different mechanisms of headache In the two sexes.