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Headache in children in Dutch general practice
J C van der Wouden1, P van der Pas, M A Bruijnzeels
1Department of General Practice, Erasmus University Rotterdam, The Netherlands. vanderwouden@hag.fgg.eur.nl
Insights
Headache is common in general practice for children, often linked to infections. For idiopathic headaches, consider psychosocial factors like family or school issues.
Area of Science:
- Pediatrics
- General Practice
- Epidemiology
Background:
- Headache is a frequent reason for pediatric consultations in general practice.
- Understanding its prevalence, diagnosis, and management is crucial for primary care providers.
Purpose of the Study:
- To detail the incidence of headache in children presenting to general practice.
- To analyze the diagnoses and management strategies employed for pediatric headaches.
- To investigate the association of headaches with infectious and psychosocial factors.
Main Methods:
- Utilized data from the Dutch national survey of morbidity and interventions in general practice.
- Analyzed 63,753 children aged 0-14 years across 103 general practices.
- Calculated incidence rates for headache presentations and specific diagnoses like idiopathic headache.
Main Results:
- Headache occurred in 634 episodes, with an incidence of 40.2 per 1000 person-years.
- Over half of headaches were linked to infections, primarily upper respiratory tract infections.
- Idiopathic headache incidence was 7.3 per 1000 person-years, increasing with age and higher in girls; psychosocial issues were noted in non-infectious cases.
Conclusions:
- Pediatric headache is a common general practice issue, frequently associated with infections.
- General practitioners should consider psychosocial factors in children diagnosed with idiopathic headache.
Aim:
To describe the occurrence of headache in general practice, the diagnoses made in general practice, and the management.
Method:
Data from the Dutch national survey of morbidity and interventions in general practice were used. The practice population (103 practices) comprised 63,753 children aged 0-14 years.
Results:
In 634 episodes, headache was a reason for encounter. The incidence of headache presented to the general practitioner was 40.2 per 1000 person years. More than half of the episodes were related to an infectious disease, among which upper respiratory tract infections predominated. The incidence rate of the diagnosis idiopathic headache was 7.3 episodes per 1000 person years. The incidence increased with age and was higher in girls than in boys. In only 12% of cases of idiopathic headache were special investigations carried out, mostly blood examinations. Medication was prescribed in 27% of all episodes of idiopathic headache. In the absence of an infectious disease, many headache episodes were associated with psychosocial problems. Family problems and school problems were mentioned most often.
Conclusion:
Headache in children as reason for encounter is a common problem in general practice, often associated with an infectious disease. When confronted with a child with idiopathic headache, the general practitioner should be aware of a possible psychosocial component.