To examine associations of different types of headaches with child and family problems, Anttila et al. (2004) asked all 1,409 sixth graders in Turku, Finland to complete questionnaires regarding headaches. For the 1,135 (81%) who completed questionnaires, 154 (14%) were identified as having migraine headaches and 138 (12%) were identified as having tension headaches, according to international criteria for these kinds of headaches. An additional 20% had primary headaches that did not meet the international criteria and 12% had headaches associated with identified physical abnormalities. Headaches were thus quite common, with only 36% of the children reporting that they did not suffer from headaches. Clinical evaluations were then performed on randomly selected samples of children whose questionnaire data met criteria for migraine or tension headaches or for being free of headaches. Children who were confirmed to meet diagnostic criteria for migraine or tension headaches or to be free of headaches were then compared with respect to scores on the CBCL and on the Family Assessment Device (FAD) completed by parents and on the Children's Depression Inventory (CDI) completed by the children. CDI scores did not differ significantly among the three groups. However, after correction for the number of comparisons, children with migraine headaches had significantly higher scores than children without headaches for CBCL Total Problems, Internalizing, Somatic Complaints (the headaches item was omitted for all respondents), and Social Problems, as well as higher family problem scores on the FAD. Children with migraine headaches also had significantly higher scores than children with tension headaches on the Somatic Complaints syndrome, while children with tension headaches had significantly higher scores than children without headaches on the Somatic Complaints syndrome and on family problems. The authors concluded that "The association between psychiatric symptoms and headaches shows differences between different headache types" (p. 412).

Reference:
Anttila, P., Sourander, A., Metsahonkala, L., Aromaa, M., Helenius, H., & Sillanpaa, M. (2004). Psychiatric symptoms in children with primary headache. Journal of the American Academy of Child & Adolescent Psychiatry, 43, 412-419.

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