Childhood headache, stress in adolescence, and primary headache in young adulthood: A longitudinal cohort study

Objectives.-To determine the association between childhood history of headache, adolescent stress, and headache syndromes (determined by International Headache Society criteria) in young adulthood. Background.-The association between stress and tension-type headache has recently been challenged. Little is known about stress and other headache subtypes, particularly among young people from the general population. Design.-Members of the longitudinal Dunedin Multidisciplinary Health and Development Study participated in this study, Study members were asked about headache characteristics/symptoms at aged 26 (96% of the living cohort), and historical records were examined to ascertain headache history (younger than 12 years) and the reporting of stressful life events at aged 15 years. Results.-Study members with childhood headache were significantly more likely to report adolescent stress than those without headache. High-intensity stress during mid adolescence increased the likelihood of migraine diagnosis. In those with combined headache (migraine as well as tension-type headache), this relation held only for those with a history of headache. Stress associated with bodily changes during mid adolescence was the only significant predictor of tension-type headache. Conclusions.-Childhood headaches are related to the appraisal of life events reported during mid adolescence. Childhood headaches also appear to confer a specific risk for the development of combined headache. There was little evidence for a prospective relation between stress in mid adolescence and tension-type headache in young adulthood, supporting claims that proximal (rather than distal) stress is associated with this disorder.