Factors related to school absenteeism in adolescents with recurrent headache.

Objective: To examine possible risk and protective factors for school absenteeism among adolescents referred to a hospital-based behavioral treatment program.

Design: Data obtained from intake interviews, screening questionnaires, and baseline headache diaries of 283 consecutive adolescents referred for behavioral treatment of recurrent headache were reviewed for demographics, length of headache history, headache type, current headache activity, symptoms of anxiety and depression, perceived self-efficacy regarding headache control, school performance, participation in extracurricular activities, and school absenteeism. The study population was divided into 2 groups at the median number of days missed due to headache in the previous 6 months that school was in session. Adolescents who missed 2 or less days of school due to headache (low absenteeism) were compared with those who missed more than 2 days (high absenteeism).

Results: Compared with the low absenteeism group, the high absenteeism group had higher scores on the Children's Depression Inventory (8.7 +/- 6.5 versus 6.8 +/- 6.2, P <.05) and lower academic performance (2.1 +/- 1.0 versus 1.7 +/- 0.8, P <.0001). The 2 groups were not statistically different in age, sex, length of headache history, type of headache, current headache frequency or intensity scores, anxiety scores, self-efficacy ratings, or participation in extracurricular activities.

Conclusions: In a referred population, students who missed more school due to headache had higher depression scores and lower academic performance than students who missed less school. A directional relationship, however, cannot be implied from these results. Future studies should investigate the complex relationship between recurrent adolescent headache, potential risk or protective factors, and school absenteeism.