BMJ 2001;322:1145 ( 12 May )

Papers

Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study

Paul Fearon, clinical lecturer,  Matthew Hotopf, clinical senior lecturer. 

Institute of Psychiatry and Guy's, King's and St Thomas's School of Medicine, De Crespigny Park, London SE5 8AF

Correspondence to: P Fearon p.fearon{at}iop.kcl.ac.uk

Objective: To elucidate the associations between frequent headache and psychosocial factors in childhood and to determine whether such children are at an increased risk of headache, multiple physical symptoms, and psychiatric symptoms in adulthood.
Design: Population based birth cohort study.
Setting: General population.
Participants: People participating in the national child development study, a population based birth cohort study established in 1958.
Main outcome measures: Headache, multiple physical symptoms, and psychiatric morbidity at age 33.
Results: Headache in childhood was associated with several psychosocial factors. Prospectively, children with frequent headache had an increased risk in adulthood of headache (odds ratio 2.22, 95% confidence interval 1.62 to 3.06), multiple physical symptoms (1.75, 1.46 to 2.10), and psychiatric morbidity (1.41, 1.20 to 1.66). The outcomes of headache and multiple physical symptoms were not accounted for by psychiatric morbidity.
Conclusion: Children with headache are at an increased risk of recurring headache in adulthood and may complain of other physical and psychiatric symptoms. Strategies for coping with psychosocial adversity in childhood may improve the prognosis in adulthood.

What is already known on this topic Common somatic symptoms in childhood are associated with psychosocial factors and may increase the risk of physical and psychiatric symptoms in adulthood No study has yet examined at the general population level the outcome as an adult of headache, the commonest somatic complaint in childhood What this study adds Children who mention headache are more likely to experience psychosocial adversity and to grow up with an excess of both headache and other physical symptoms and psychiatric symptoms

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