두통이 있는 학생들에서 두통과 관련된 장애와 예측인자:

Characterization and Predictors of Headache-Related Disability among School Children:

목적: 두통은 학생들이 흔하게 경험하는 신경학적 증상이며, 반복적으로 두통이 있으면 학교 결석이나 학업 및 과외 활동에도 지장을 초래할 수 있다. 국내에서는 아직 이에 연구가 없는 실정이다. 본 연구는 우리나라 학생들의 두통에 의한 장애 정도를 평가하고 두통에 의한 장애 예측인자를 알아 보고자 하였다. 방법: 이 연구는 횡단적 단면 학교 기반 연구로 총 5,039명(남자 2,405, 여자 2,634명)이 참여 하였으며, 나이 범위는 6-18세 이었다. 설문지는 국제두통분류 제 2판에 따라 구성하였고 학교에서 선생님을 통해 배포하고 수집하였다. 결과: 두통이 있는 학생 1,465명 중 이 연구를 위한 질문에 온전히 답한 학생은 666명이었다. Grade 1의 장애를 보인 학생은 88.6%이였으며, 평균 PedMIDAS는 5.11±11.17 이었다. 나이가 들수록 두통에 의한 장애가 더 심해지는 경향이었으며, 16-18세에서 가장 심했다. 편두통이 있는 학생이 다른 두통이 있는 학생보다 두통에 의한 장애가 더 심했다. 두통에 의한 장애 예측인자는 심한 두통(P=0.028, 빈번한 두통(P=0.003), 방문 전 병력이 긴 두통이었다(P=0.008). 결론: 두통에 의한 장애는 나이가 들수록 더 심하였으며, 편두통이 있는 학생이 가장 심했다. 두통에 의한 장애 예측인자는 심한 두통, 빈번한 두통, 방문 전 병력이 긴 두통이었다.

Purpose: Headache is a frequent neurological symptom in school aged individuals and recurrent headache has significant disabling effects among children and adolescents that manifest as school absenteeism, decreased extracurricular activities, and poor academic performance, as shown in previous studies. In Korea, there has not yet been a population-based study of headache-related disability in children and adolescents. We sought to estimate headache-related disability and investigate relevant predictors of disability due to headaches among schoolchildren in South Korea. Methods: This was a cross-sectional school-based study. We surveyed 5,039 (boys 2,405, girls 2,634) students aged 6-18 years. Among 1,465 students with headache, six hundred sixty-six schoolchildren (225 boys, 441 girls) completed all questionnaires. The questionnaires collected demographic data, in addition to headache specific questions consistent with International Classification of Headache Disorder criteria, 2nd edition. Disability was evaluated using the 6-question Pediatric Migraine Disability Assessment (PedMIDAS). Results: : Six hundred sixty six school children and adolescents (225 boys, 441 girls) among 1,465 students with headaches completed all questionnaires. The percentage of headache sufferers with grade I disability was 88.6%. The mean (±standard deviation) PedMIDAS score was 5.11±11.17. There was a trend towards more severe disability in the older age groups, particularly among the 16 to18 year-olds. Students with migraine had the highest PedMIDAS scores (6.69±10.66) whereas students reporting other types of headache had the lowest scores (3.81±7.52). The predictors of headache-related disability were intensity (P=0.028), frequent headache (P=0.003), and longer duration of symptoms prior to presentation (P=0.008). Conclusion: : A trend towards a more severe disability was observed in the older age group. Schoolchildren with migraine had the most headache-related disability. The predictors for headache-related disability were intensity, frequent headache, and longer duration of symptoms prior to presentation.