Objectives.

The purpose of the study was to examine the occurrence of childhood headache at the start of school.

Study Design.

An unselected population-based questionnaire study on the occurrence of headache was conducted in 1433 children between the ages of 6 and 7 years old (ranging from 6 years 8 months to 7 years 8 months) who started school in 1992. The first questionnaire was given within 3 months of school entry in 1992. Of 1433 children, 1290 responded satisfactorily to the second headache questionnaire at the end of the second school year. The children (n= 725) who had had headache in 1994 were sent a more detailed questionnaire concerning risk factors of headache.

Results.

A significant increase in the incidence density of overall headache in children was found during the first 12 school months compared with the 6 months immediately before school started or with the subsequent 6 school months (13th–18th month). The increase was attributable to occasional headache. During the first school months, the frequency of headache increased in 20% of children who had had headache before the 6 months preceding the start of school. The mothers and fathers of 129 children who started to have headache after school entry had a higher socioeconomic status than the mothers and fathers of children who had headache before the start of school. No significant difference in family history of headache or school-related factors was found among children. Predictably, the incidence density of recurrent headache after school start was higher than before school start. However, occasional headache showed a distinct peak at school start but regained its initial level at the end of the second school year.

Conclusion.

School start appears to increase the incidence of overall headache (occasional headache in particular) in children, independent of other factors.

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