The main purpose of the present study was to evaluate behavioural and lifestyle patterns in adolescents with primary headache in a cohort of junior college going students

Literature regarding the relation between primary headaches and symptoms of anxiety, depression and lifestyle patterns is scarce. Assessment of these co-morbid disorders may improve the management of adolescents with primary headaches. 

A cross-sectional, prospective study was conducted in students from Western India from Latur district. 481 adolescents aged 13 to 17 years were interviewed about their headache complaints and completed a comprehensive Physical Health Questionnaire 9(PHQ-9) for depression and Generalised Anxiety Disorder 7(GAD-7) scale for anxiety assessment. On both the scales, cut-off values of 5,10,15 were taken to categorize patients to mild, moderate and severe groups respectively. Data about lifestyle patterns like sleep, social media use and eating disorders was also collected.

Primary headache was noted in 187 (38.8%) of the study population, predominantly in girls (56.1% vs 34.5%; p<0.001). The average hours of reported sleep were 5.5±2.6 hours; with reportedly 6.6±5.8 hours of time spent of social media every week. Only 175(36.3%) adolescents reportedly exercised.

Not only was the average PHQ-9 score more in student with headache (9.5±5.2 vs. 5.7±4.1; p<0.001), both moderate (27.3% vs 10.9%; p<0.001) and severe (13.4% vs 2.6%; p<0.001) depression was more common in them.

Similarly, the average score on GAD-7 was higher in students with headache (7.4±4.5 vs 4.4±3.9; p<0.001).

While there was no difference between the groups for time spent on social media or duration of sleep and exercise, more number of students with headache reports lack of adequate sleep (33.7% vs 24.6%; p=0.017)

There is significant sleep deprivation. Anxiety, depressive and sleep patterns are associated with primary headache, and should accordingly be considered a part of the clinical assessment and management of adolescents with headache.