Failure to mourn as a possible contributory factor to headache onset in adolescence

Patients who have suffered from chronic headaches frequently are unable to identify a triggering physical or emotional event that precipitated the headache process. This study examined the headache histories of teenage headache patients, the majority of whom were found to be depressed, and found that personal loss occurred within 12 months of headache onset in 11 of 15 cases. Among the losses that were identified were those involving terminal illness and death of family members, separation and/or divorce in the family, or change of residence from a familiar area. It is recommended that opportunities for dealing with feelings about their losses should be presented to patients, whether or not the patients express a need for this. Furthermore, it is recommended that patients of any age who cannot identify a triggering event prior to the onset of their headache histories should be questioned in detail about the possible correlation with personal loss.