Background
Evidence regarding associations of headache with other somatic conditions in children has been largely based on clinical samples. The objective of this study was to examine the pattern and extent to which other physical conditions are comorbid with migraine and other headaches among youth in a representative sample of the US population.
Methods
The National Comorbidity Survey-Adolescent Supplement (NCS-A) is a face-to-face survey of adolescents aged 13–18 years in the continental United States. Sufficient information to assess the International Headache Society criteria for Migraine with and without Aura over past 12 months was available in the diagnostic module. A caretaker/parental self-administered report (PSAQ) was used to assess a broad range of other physical conditions. The sample for these analyses included 6843 adolescents with systematic caretaker/parent reports.
Results
Individuals with any headaches reported higher rates of other neurologic conditions such as epilepsy (OR 2.02 [95% CI: 1.04–3.94]), persistent nightmares (OR 2.28 [95% CI: 1.34–3.87]), and motion sickness (OR 1.6 [95% CI: 1.07–2.4]), as well as abdominal complaints (OR 2.36[95%CI: 1.59–3.51]). Adolescents with migraine more often reported asthma (OR 2.22 [95% CI: 1.26–3.92]) or seasonal allergies (OR 1.66 [95%CI: 1.12–2.48]) compared to those with non-specific headache.
Conclusions
Adolescent migraine is associated with inflammatory conditions such as asthma and seasonal allergies, and with epilepsy, persistent nightmares and motion sickness. Findings suggest that comorbid medical conditions should be evaluated comprehensively in determining treatment options in youth with headache. Such comorbidity could also be an important source of clinical and etiologic heterogeneity in migraine.