The prevalence of headache in children aged 7-16 years, representing districts of the city of Goteborg with socioeconomic, family, and school variables, is reported from Sahlgrenska Hospital, Goteborg, Sweden. Data obtained by questionnaires from 1297 pupils, representative of the city population, showed 26% with “headache once a month” and 6% at daily intervals or several times a week “frequent headache.” The prevalence of “headache once a month or more” increased with age and school grade, from 16% in first grade to 42% in grade 9. The prevalence of “frequent” headache, presumably of tension-type, increased from 3% in second grade to 10% in third grade. Girls in grades 7-9 were affected more than boys with respect to both types of headache. The risk of frequent headache correlated with class size, increasing with larger classes in lower school, grades 1-3. In intermediate classes, grades 4-6, headache frequency was higher in districts with high unemployment. [1]

COMMENT. The increase in headache frequency in third grade was thought to be related to the larger classes and more targeted schoolwork. The increased prevalence in higher school levels was related to the higher frequency among girls, possibly due to hormonal changes and greater sensitivity to interpersonal conflicts and family stress. Parental separation or divorce and marital problems have been related to recurrent headache in children and adolescents, but these were not risk factors in the present study.