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PAPERS:
Paul Fearon and Matthew Hotopf
Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study
BMJ 2001; 322: 1145 [Abstract] [Full text]
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[Read Rapid Response] Headache in childhood
Barry Paul   (8 June 2001)

Headache in childhood 8 June 2001
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Barry Paul,
3rd year medical student
Newcastle University

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Re: Headache in childhood

Dear Editor,

On reading the paper by Fearon and Hotopf1 on headache in childhood, a number of issues came to light. We felt that the great strength of the paper was the size of the National Child Development Study (NCDS). It captured a wide spectrum of the population and the follow up of participants over 33 years was impressive.

However, we question the use of the NCDS as a basis for this most recent study. The authors aimed to address the complex interactions between social factors and headache in childhood, as well as the implications in later life. The NCDS was designed as a broad study of child development rather than to investigate such specific and complex issues.

Headache is a difficult symptom to define, and the question concerning this was, in our view, over-simplified. It was also unclear whether organic causes of headache were considered. For example, they did not account for headache associated with infection or epilepsy. Fearon and Hotopf have addressed important adult implications of a common childhood complaint. It is encouraging that they have raised these issues, and their study will hopefully prompt others to continue research.

We would suggest a modified cohort study to be undertaken using standardised symptom and psychiatric scales for all variables.

Yours faithfully,

Ruth Bell
Esther Curnock
Jenny Gilmour
Barry Paul
Sheila Taylor

Stage 3 MBBS (University of Newcastle upon Tyne)

References:

1.Fearon P, Hotopf M. Relation between headache in childhood and physical and psychiatric symptoms in adulthood: national birth cohort study. BMJ 2001; 322: 1145-8.