Інформація призначена тільки для фахівців сфери охорони здоров'я, осіб,
які мають вищу або середню спеціальну медичну освіту.

Підтвердіть, що Ви є фахівцем у сфері охорони здоров'я.

International neurological journal 8 (78) 2015

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Epidemiologic and Clinical Characteristics of Tension-Type Headache among Adolescents of Kharkiv

Authors: Dubenko O.Ye., Stepanchenko K.A. - Kharkiv Medical Academy of Postgraduate Education, Kharkiv, Ukraine

Categories: Neurology

Sections: Clinical researches

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Summary

Цель настоящего исследования — установить частоту распространенности, факторы риска и особенности клинического течения головной боли напряжения в популяции подростков г. Харькова. Проведено скрининговое исследование 2342 подростков — учеников харьковских школ в возрасте 13–17 лет с использованием опросника, диагностических критериев Международного общества головной боли, определение продолжительности, интенсивности головной боли, а также оценка влияния головной боли на повседневную активность. Установлено, что распространенность головной боли напряжения у подростков харьковских школ составила 61,1 %, при этом чаще наблюдалась ее редкая эпизодическая форма — у 59,7 %, частая эпизодическая форма — у 33,8 %. Хроническая форма головной боли напряжения отмечалась только у 6,5 % подростков. Наиболее частыми факторами риска были неблагоприятная обстановка в семье, низкая физическая активность, курение. Наличие головной боли напряжения оказывало негативное влияние на повседневную активность подростков.

Мета дослідження — установити частоту поширеності, фактори ризику та особливості клінічного перебігу головного болю напруги в популяції підлітків м. Харкова. Проведено скринінгове дослідження 2342 підлітків — учнів харківських шкіл віком 13–17 років із використанням опитувальника, діагностичних критеріїв Міжнародного товариства головного болю, визначення тривалості, інтенсивності головного болю, а також оцінку впливу головного болю на повсякденну активність. Установлено, що поширеність головного болю напруги в підлітків харківських шкіл становила 61,1 %, до того ж частіше спостерігалася його нечаста епізодична форма — у 59,7 %, часта епізодична форма — у 33,8 %. Хронічна форма головного болю напруги відмічалася тільки в 6,5 % підлітків. Найчастішими факторами ризику були несприятлива ситуація в родині, низька фізична активність, паління. Наявність головного болю напруги негативно впливала на повсякденну активність підлітків.

The objective of this study — to determine the prevalence, risk factors and features of the clinical course of tension-type hea­dache in the population of Kharkiv adolescents. We have carried out a screening study of 2,342 adolescents — pupils of Kharkiv schools aged 13–17 years using questionnaire, diagnostic criteria of the International Headache Society; duration, severity of headache were determined, as well as the impact of headache on daily activities. It was found that the prevalence of tension-type headache in adolescents of Kharkiv schools was 61.1 %, while its rare episodic form was more common — 59.7 %, frequent episodic form — 33.8 %. The chronic form of tension-type headache was detected in only 6.5 % of adolescents. The most frequent risk factors were the unfavorable situation in the family, physical inactivity, smoking. The presence of tension-type headaches had a negative impact on daily activities of adolescents.


Keywords

головная боль напряжения, подростки, распространенность, факторы риска.

головний біль напруги, підлітки, поширеність, фактори ризику.

tension-type headache, adolescents, prevalence, risk factors.

The Atlas of Headache Disorders presents data acquired by World Health Organization in collaboration with Lifting the Burden: the Global Campaign against Headache. Most of the information was collected from 101 countries. The Worldwide prevalence of tension-type headache an average of 42% in adults, the episodic tension-type headache reported by over 70% of some population, chronic tension-type headache affects 1-3% adults, often beginning during the teenage year and peak levels in the 30 year. In Ukraine the prevalence of tension-type headache in adolescent is poor documented. Aim of this study – to determine the prevalence of tension-type headache and identify the risk factors and clinical characteristics in the population of Kharkiv adolescents.

Patients and methods. A random sample of 2342 adolescents in age 13-17 years of Kharkiv schools was screened by using questionnaire, diagnostic criteria of International Headache Society (ICHD-II). The questionnaires consist of questions related to demographic, social, housing and headache characteristics of the subjects. The headache intensity measured by visual analogue scale, the influence headache on daily activity – by disability score PedMIDAS.

Comparison between means was calculated by Fisher’s criteria.

Results. Applying the ICHD-II criteria, neurological and physical examination of 2342 subjects the 72,2% had a primary headache, migraine had 10,6%, tension-type headache had 61,1%, other primary headache – 0,5%. The girls had a significantly higher frequency of headaches (p<0,01). Tension-type headache was the most common type of headache in Kharkiv adolescents and registered in 84,6% persons with primary headache, episodic tension-type headache in 79,1%, infrequent episodic tension-type headache in 59,7%, frequent episodic tension-type headache in 33,8%, chronic tension-type headache in 5,5%. Headache intensity by visual analogue scale - 4,9±1,3 in girls and 4,6±1,2 in boys.

In the analysis of social factors, it was found that adolescents with tension-type headache was significantly less likely to attend sports sections - 27.3% with 38.2% in the control group (p<0.05). The duration of work at the computer in adolescents with tension-type headache was 1,4±0,2 hours and 1,0±0,4 hours in the control group (p<0.05). The main group of adolescents with tension-type headache had significantly more frequent poor adaptation to the preschool and school institutions (p<0.01) than in the control group. Adolescents with tension-type headache were significantly more exposed to unfavorable psychological factors in the family - in 79.3% of cases with 49.6% in the control group (p<0.05). Adolescents with frequent episodic and chronic tension-type headaches had significantly more frequent alcoholic excesses (p<0.01) than in the control group. The dominant frequency risk factor for adolescents with tension-type headache - smoking (41%) (p<0.01).

Provoking factors in adolescents with tension-type headache were changing weather patterns in 185 people (57.8%), emotional and stressful situations (stress and relaxation after stress) in 121 adolescents (37.2%), conflicts with teachers (31.9%) and peers (28.8%), rarely with their parents (21.9%); noise, lack of sleep, vestibular load, intellectual overstrain were observed in 19.9% of children with infrequent episodic tension-type headache, 22% with frequent episodic tension-type headache and 48.2% with chronic tension-type headache; bright light (6.9%), strong odors (9.7%), alcohol (3.4%), excess sleep (4.7%), hunger (7.5%), menstruation (0.9%), a long stay in an uncomfortable position (4.1%).

Tension-type headache facilitators were sleep (60.9%), appointment analgesics (55.3%), massage of the neck (11.3%), eating (5.6%), use of a tension bandage (2.5 %), heat and cold in the head (2.2% and 2.5%, respectively).

Adolescents with infrequent episodic tension-type headache often noted a significant reduction in daily activity with a total average score of 4,1±1,2 (on a scale PedMIDAS), adolescents with frequent episodic tension-type headache significantly more often, compared to infrequent episodic tension-type headache, had light to moderate decrease in daily activity (total average score - 19,5±2,7), adolescents with chronic tension-type headache had significantly higher light to moderate decrease in daily activities, compared with patients with infrequent and frequent forms of episodic tension-type headache, and rarely showed a slight degree of decrease in daily activity (total average score - 32±4,9).

Conclusions. The frequency of tension-type headache in adolescents from schools in the city of Kharkiv was 61.1%. The most common form was infrequent episodic tension-type headache. Chronic tension-type headache was observed in 6.5%. The most common risk factors were the unfavorable situation in the family (parents quarrel, divorce), smoking, low physical activity. Tension-type headache affected the daily activities of adolescents, which increases with the increase in frequency and duration of tension-type headache.


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