The British Journal of Psychiatry (2009) 194: 111-116. doi: 10.1192/bjp.bp.108.052159
© 2009 The Royal College of Psychiatrists
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Association of headache with childhood adversity and mental disorder: cross-national study

Sing Lee, MBBS, FRCPsych

Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong

Adley Tsang, BSoSc

Hong Kong Mood Disorders Center, The Chinese University of Hong Kong, Hong Kong

Michael Von Korff, ScD

Center for Health Studies, Group Health Cooperative, Washington, USA

Ron de Graaf, PhD

Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands

Corina Benjet, PhD

National Institute of Psychiatry Ramón de la Fuente, Mexico

Josep Maria Haro, MD, MPH, PhD

Sant Joan de Deu-SSM, Barcelona, Spain

Matthias Angermeyer, MD, PhD

Center for Public Mental Health, Austria

Koen Demyttenaere, MD, PhD

Department of Neurosciences and Psychiatry, University Hospitals Gasthuisberg, Belgium

Giovanni de Girolamo, MD

Regional Health Care Agency, Emilia-Romagna Region, Bologna, Italy

Isabelle Gasquet, MD

Hôpitaux de Paris, Paris, France, Mission Performance et Prospective Médicales (Direction de la Politique Médicale, AP-HP), France

Kathleen Merikangas, PhD

National Institute of Mental Health, Bethesda, Maryland, USA

José Posada-Villa, MD

Colegio Mayor de Cundinamarca University, Colombia

Tadashi Takeshima, MD

National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan

Ronald C. Kessler, PhD

Department of Health Care Policy, Harvard Medical School, Massachusetts, USA

Correspondence: Professor Sing Lee, Director, Hong Kong Mood Disorders Center, 7A, Block E, Staff Quarters, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. Email: singlee{at}cuhk.edu.hk

Declaration of interest

None. Funding detailed in Acknowledgements.

Background

Community studies about the association of headache with both childhood family adversities and depression/anxiety disorders are limited.

Aims

To assess the independent and joint associations of childhood family adversities and early-onset depression and anxiety disorders with risks of adult-onset headache.

Method

Data were pooled from cross-sectional community surveys conducted in ten Latin and North American, European and Asian countries (n=18 303) by using standardised instruments. Headache and a range of childhood family adversities were assessed by self-report.

Results

The number of childhood family adversities was associated with adult-onset headache after adjusting for gender, age, country and early-onset depression/anxiety disorder status (for one adversity, hazard ratio (HR)=1.22–1.6; for two adversities, HR=1.19–1.67; for three or more adversities, HR=1.37–1.95). Early and current onset of depression/anxiety disorders were independently associated (HR=1.42–1.89) with adult-onset headache after controlling for number of childhood family adversities.

Conclusions

The findings call for a broad developmental perspective concerning risk factors for development of headache.


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