Prevalences of primary headache symptoms at school-entry: a population-based epidemiological survey of preschool children in Germany

Abstract

Primary headache and functional abdominal pain prevalences in an unselected populationbased sample of German preschool children and their parents (n=885) were collected in relation to health-related quality of life and sociodemographic variables. The pain symptoms were assessed according to IHS classification (2004) and Rome-II criteria (1999) during the 2004 data census. The participation rate was 62.7%, with an equal gender distribution. The focus of this paper lies on the symptom-oriented point prevalences for primary headaches of preschool children: 3.6% headache, 33.2% abdominal pain, 48.8% headache+abdominal pain and 14.4% without pain. High comorbidities for pain-affected children have been found. Pain intensities differ significantly only for abdominal pain (one-way ANOVA F=3,339, df=4/445, p=0.010*), not for headaches. However, recurrent headaches show a striking ratio in favour of boys (10:1). Children at preschool age have high quality-of-life measures, already influenced negatively by paediatric pain experiences (one-way ANOVA: F=9,193, df=4/546, p=0.000**). Headache and abdominal pain are relevant for children's everyday life; hence, simultaneous and prospective assessment is an essential issue in public health research.

Headache and recurrent abdominal pains in preschool children

“…Therefore only 3.6% of this sample suffered from recurrent headache, with a boy/girl ratio of 10 to 1 [3]. Along with this finding, in outpatient headache sufferers under 6 years of age, a greater male gender prevalence and shorter duration of headache attacks were reported [4].…”

“…The study of Ostkirchen et al [3] examined the prevalence of primary headache and functional abdominal pains in 555 preschool children assessed by a self-administered questionnaire. In this issue the Authors reported that 85.6% of the sample suffered from pain, mainly abdominal pains (33.2%), often associated with headache (48.8%).…”

“…An other issue in Ostkirchen's study is that children experiencing combined headache and abdominal pains reach higher headache intensity levels and both types of pain experiences are relevant for children's everyday life because they contribute to an increase of vulnerability [3].…”

Somatic symptoms, severe mood dysregulation, and aggressiveness in preschool children

“…Furthermore, most researches have been devoted to studying schoolchildren and adolescents. Studies focused on preschool children are scarce [14,15,38]. Since research suggests that somatic symptoms in adults have their origins in childhood and maintain certain continuity [3,9,18,34], it seems important to verify the presence of symptoms at early ages.…”

Incontinence and headache in preschool children

“…This rate is higher than in our study and could be due to the older age of the children. Also, parents seem to underestimate the intensity of the headache in their preschool children …”