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Education and Social Life: The Impact of Headache on Participation in Children and Adolescents Attending a Headache Clinic-A Case-Control Study

A. Berring-Uldum, L. T. Skovgaard, Maria J Miranda, N. Debes

Pediatric Neurology, 2025

131 participants · 11 citations

Abstract

BACKGROUND

Headaches can have devastating effects on educational and social opportunities. Headache-related absences are linked to poorer school performance, reduced likelihood of attaining higher education, social isolation, and fewer friendships. We assessed the impact of headaches on participation in school and other activities in children and adolescents attending a headache clinic compared to control subjects.

METHODS

This cross-sectional, case-control study included patients from the Pediatric Headache Outpatient Clinic and control subjects from schools. Participation was measured with Child and Adolescent Headache-Attributed Restriction, Disability, Social Handicap, and Impaired Participation and Pediatric Migraine Disability Assessment questionnaires. Primary outcomes were missed school, missed other activities, and parents' missed work due to children's headache.

RESULTS

Three hundred fifty-four patients and 131 control subjects participated. In the past four weeks, patients had more absences than control subjects, with 1.8 vs 0.3 missed school days, 1.2 vs 0.3 days left early from school, 4.4 vs 0.7 days missed other activities, and 0.8 vs 0.2 lost parental workdays (all P < 0.001). In subgroup analyses, patients with tension-type headache were most severely affected, and compared to patients with migraine had 18.9 vs 3.7 headache days (P < 0.001), 2.3 vs 1.1 missed school days (P = 0.337), 5.6 vs 1.8 days missed other activities (P < 0.001), and 0.4 vs 0.6…

How strong is the evidence?

Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 131 participants or records.

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