Headache in adolescents in Dutch general practice

Area of Science:

• General Practice
• Adolescent Health
• Neurology

Background:

• Headache is a frequent complaint in adolescents presenting to general practitioners.
• Understanding the epidemiology and management of adolescent headaches is crucial for primary care.

Purpose of the Study:

• To investigate the incidence, diagnosis, and management of headache in adolescents within general practice.
• To explore the role of psychosocial problems in adolescent idiopathic headache.
• To determine referral patterns for adolescent headaches.

Main Methods:

• Utilized data from the Dutch national survey of morbidity and interventions in general practice.
• Analyzed 650 headache episodes from a population of 37,187 adolescents (aged 12-18 years) across 103 practices.
• Examined diagnoses, associated psychosocial factors, and specialist referral rates.

Main Results:

• The incidence of headache in general practice was 69.9 per 1000 person-years, with girls affected twice as often as boys.
• Idiopathic headache occurred at an incidence of 18.0 per 1000 person-years; 25% of all headache episodes were diagnosed as idiopathic.
• Psychosocial problems were associated with 21% of idiopathic headaches, yet only 3-4% of headache episodes resulted in specialist referrals.

Conclusions:

• Headache is a common reason for adolescent visits to general practitioners, frequently associated with infectious diseases.
• General practitioners identify psychosocial issues contributing to idiopathic headaches but rarely refer these cases.
• Adolescent headaches, even when linked to psychosocial factors, are infrequently referred for specialist care.