Prevalence and clinical characteristics of primary headaches among school children in South Korea: A nationwide survey

Objectives. To determine the 1-year prevalence of headache and clinical characteristics of primary headaches among school children in South Korea. Background. Many population-based studies have estimated the 1-year prevalence of headache, migraine, and tension-type headache (TTH). The results of those studies vary in terms of race and region. There have been few epidemiological population-based studies of headache in children and adolescents in Korea. Methods. We conducted a cross-sectional school-based study of a randomized and proportional sample of 5360 boys and girls. All 180 sampled schools participated in this study. The questionnaires collected demographic data in addition to specific questions about headache according to the International Classification of Headache Disorder criteria, 2nd Edition. Valid questionnaires were returned by 94.1% of the sample population. Modified criteria changed the "duration" of migraine (>1 hour instead of 4 hours). Results. The prevalence of headache among school children was 29.1% (1465/5039) in South Korea. The prevalence of headache in girls (33.4%) was significantly higher than in boys (24.4%) (P <.001). The mean age of students with headaches (14.02 ± 3.03) was significantly higher than students without headaches (12.73 ± 3.36) (P <.001). The prevalence of headache according to region was 30.7% among students in urban, 31.2% in suburban, and 21.6% in rural areas. The prevalence of headache according to age was 20.8% among students ∼6-12 years, 32.0% ∼13-15 years, and 38.2% ∼16-18 years. The prevalence according to headache types was 8.7% (boys 7.0%, girls 10.3%) in migraine, 13.7% (boys 10.7%, girls 16.3%) in TTH, and 6.7% in others. The mean frequency, severity of headache, and duration of symptoms were significantly higher in girls than in boys (P <.001). Conclusions. Recurrent primary headaches are quite prevalent among school-aged children and adolescents in South Korea, and the prevalence rates are similar to those reported elsewhere. TTH was more common than migraine. The prevalence of migraine headache increased with age. The prevalence rate of headache in students in urban and suburban areas was significantly higher than the rate of students in rural areas.