Researchers at the University of Pernambuco, Recife, Brazil interviewed a randomly selected group of university students to determine the one-year prevalence of headache, types of headache, and their association with academic performance. The researchers used several instruments to assess outcomes, including the International Headache Society criteria to characterize headaches as migraine or tension-type1 and the Headache Impact Test to assess the effect of headaches on daily activities (pain severity, role functioning, social functioning, vitality, emotional distress, and cognitive functioning).2 The Hospital Anxiety and Depression Scale was used to verify the occurrence of anxiety and depression among study participants.3 The independent effect of headaches on academic performance was assessed after controlling for confounding variables such as alcohol consumption, workload, and co-existence of anxiety and/or depression.
A total of 380 students were randomly selected for the study and 344 (90%) participated. The students’ mean age was 23.4 years; 57.3% were women. Headache prevalence was 87.2% (migraine 48.5%, tension-type 42.4%) in the past 12 months. Migraine without aura (43%) was more common than migraine with aura (18.3%). In the three months before the study, 8.7% of participants sought emergency services because of headaches, 75.6% recorded analgesic use during headache, and 1.5% reported analgesic overuse. Forty-nine percent of students reported headache that had a substantial or very severe impact. Of note, 30.8% had missed class due to headache and 30.8% were less productive because of headaches. Screens for anxiety and depression were positive in 43.9% and 18.9%, respectively, of study participants. However, even after accounting for the co-existence of anxiety and depression and other confounders, the researchers found that serious-impact headaches were significantly associated with more subject failures and absenteeism, but not grade point average. Overall, no headache variables were associated with grade point average; however, participants who reportedly consumed alcohol had significantly lower grades than those who did not.
The authors conclude that headaches are common in university students, and that high-impact headaches are associated with lower academic performance.
Dr Millichap has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Headaches are common in children, and migraine headaches occur with increasing frequency through adolescence. The American Academy of Neurology (AAN) Practice Parameter, Treatment of Migraine, endorsed by the American Academy of Pediatrics, reports a migraine prevalence of 3% at age 3 to 7 years that increases to 4% to 11% at ages 7 to 11 and 8% to 23% at age 11 to 15+ years.4,5 The mean age at onset of migraine is 7.2 years for boys and 10.9 years for girls. The prevalence of migraine of 48.5% reported in the university students from the current study is more than twice that quoted in the literature for adolescents...