Primary headache and factors associated in university students: a cross sectional study
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Abstract
Introduction: Primary headaches, defined as disorders in themselves caused by independent pathomechanisms and not by other disorders, are prevalent in university students and considered one important health problems in the world. Objective: To investigate the prevalence of primary headaches and analyze associations with sociodemographic characteristics and the use of electronic devices by university students. Methods: A cross-sectional observational study analysis was carried out with a sample of 1,143 students of both genders who responded to the questionnaire on demographic, socioeconomic aspects, use of electronic devices, and on the primary headaches. Descriptive analysis, bivariate analysis, and Poisson regression were performed. Results: The overall prevalence of primary headache of 60.7%, being that, in relation to the type, 33.2% presented tension-type headache, 54.3% migraine, and 12.3% other types of headache. Regression analysis showed that female gender and income of up to two minimum wages were associated with primary headache and migraine type. The primary headache was associated with subjects of the white race; watching television and playing video games for more than 3 hours per day, for example. The sitting posture, semi-lying down, and distance from the eyes to the mobile phone and tablet longer than 20 cm were associated with primary headache and the three types of headaches. Conclusion: The results allow us to conclude that there is a high prevalence of primary headaches in college students and that socioeconomic factors related to the use of electronic devices are associated with the presence of primary headaches.
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Vitta, A. de, Biancon, R. dal B., Cornélio, G. P., Bento, T. P. F., Maciel, N. M., & Perrucini, P. de O. (2021). Primary headache and factors associated in university students: a cross sectional study. ABCS Health Sciences, 46, e021207. https://doi.org/10.7322/abcshs.2020005.1793
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16. Stovner LJ, Andrée C; On behalf of the Eurolight Steering Committee. Impact of headache in Europe: a review for the Eurolight project. J Headache Pain. 2008;9(3):139-46. http://dx.doi.org/10.1007/s10194-008-0038-6
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18. Fernandes JAA, Genebra CVS, Maciel NM, Fiorelli A, Conti MHS, De Vitta A. Low back pain in schoolchildren: a cross-sectional study in a western city of São Paulo state, Brazil. Acta Ortop Bras. 2015;23(5):235-8. http://dx.doi.org/10.1590/1413-785220152305148842
19. Bento TPF, Cornelio GP, Perrucini PO, Simeão SFAP, De Conti MHS, De Vitta A. Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health. J Pediatr. 2019;S0021-7557(19)30279-7. http://dx.doi.org/10.1016/j.jped.2019.07.008
20. Subcomitê de Classificação Internacional das Cefaleias (CIC). Classificação Internacional das Cefaleias. 2 ed. São Paulo: Alaúde, 2006.
21. Falavigna A, Teles AR, Velho MC, Vedana VM, Silva RC, Mazzocchin T, et al. Prevalence and impact of headache in undergraduate students in Southern Brazil. Arq Neuro-Psiquiatr. 2010;68(6):873-7. http://dx.doi.org/10.1590/S0004-282X2010000600008
22. Birru EM, Abay Z, Abdelwuhab M, Basazn A, Sirak B, Teni FS. Management of headache and associated factors among undergraduate medicine and health science students of University of Gondar, North West Ethiopia. J Headache Pain. 2016;17:56. http://dx.doi.org/10.1186/s10194-016-0647-4
23. Almesned IS, Alqahtani NG, Alarifi JA, Alsaawy TN, Agha S, Alhumaid MA. Prevalence of primary headache among medical students at king Saud bin Abdulaziz University for health sciences, Riyadh, Saudi Arabia. J Fam Med Prim Care. 2018;7(6):1193-6. http://dx.doi.org/10.1186/s10194-020-1074-0
24. Schroeder RA, Brandes J, Buse DC, et al. Sex and Gender Differences in Migraine-Evaluating Knowledge Gaps. J Womens Health (Larchmt). 2018;27(8):965-73. https://doi.org/10.1089/jwh.2018.7274
25. Vetvik KG, MacGregor EA. Sex differences in the epidemiology, clinical features, and pathophysiology of migraine. Lancet Neurol. 2017;16(1):76-87. https://doi.org/10.1016/S1474-4422(16)30293-9
26. Pavlovic JM, Akcali D, Bolay H, Bernstein C, Maleki N. Sex-related influences in migraine. J Neurosci Res. 2017;95(1-2):587-93. https://doi.org/10.1002/jnr.23903
27. Todd C, Lagman-Bartolome AM, Lay C. Women and migraine: the role of hormones. Curr Neurol Neurosci Rep. 2018;18(7):42. https://doi.org/10.1007/s11910-018-0845-3
28. Scher AI, Stewart WF, Liberman J, Lipton RB. Prevalence of frequent headache in a population sample. Headache. 1998;38(7):497-506. http://dx.doi.org/10.1046/j.1526-4610.1998.3807497.x
29. Lipton RB, Munjal S, Alam A, Buse DC, Fanning KM, Reed ML, et al. Migraine in America Symptoms and Treatment (MAST) Study: Baseline Study Methods, Treatment Patterns, and Gender Differences. Headache. 2018;58(9):1408-26. https://doi.org/10.1111/head.13407
30. Anderson RJ, Jackson BL. Human platelet phenol sulfotransferase: stability of two forms of the enzyme with time and presence of racial difference. Clin Chim Acta. 1984;138(2):185-96. http://dx.doi.org/10.1016/0009-8981(84)90233-x
31. Winter AC, Berger K, Buring JE, Kurth T. Associations of socioeconomic status with migraine and non-migraine headache. Cephalalgia. 2012;32(2):159-70. http://dx.doi.org/10.1177/0333102411430854
32. Kandil MR, Hamed SA, Fadel KA, Khalifa HE, Ghanem MK, Mohamed KO. Migraine in Assiut Governorate, Egypt: epidemiology, risk factors, comorbid conditions and predictors of change from episodic to chronic migraine. Neurol Res. 2016;38(3):232-41. https://doi.org/10.1080/01616412.2015.1114232
33. Lipton RB, Stewart WF, Celentano DD, Reed ML. Undiagnosed migraine headaches. A comparison of symptom-based and reported physician diagnosis. Celphalagia. 1992;152(6):1273-8. http://dx.doi.org/10.1001/archinte.152.6.1273
34. Montagni I, Guichard E, Carpenet C, Tzourio C, Kurth T. Screen time exposure and reporting of headaches in young adults: a cross-sectional study. Cephalgia. 2016; 36(11):1020-27. http://dx.doi.org/10.1177/0333102415620286
35. Szyjkowska A, Gadzicka E, Szymczak W, Bortkiewicz A. The risk of subjective symptoms in mobile phone users in Poland - an epidemiological study. Int J Occup Med Environ Health. 2014;27(2):293-303. http://dx.doi.org/10.2478/s13382-014-0260-1
36. Stalin P, Abraham SB, Kanimozhy K, Prasad RV, Singh Z, Purty AJ. Mobile Phone Usage and its Health Effects Among Adults in a Semi-Urban Area of Southern India. J Clin Diagn Res. 2016;10(1):LC14-16. http://dx.doi.org/10.7860/JCDR/2016/16576.7074
37. Zheng F, Gao P, He M, Li M, Tan J, Chen D, et al. Association between mobile phone use and self-reported well-being in children: a questionnaire-based cross-sectional study in Chongqing, China. BMJ Open. 2014;5(5):e007302. http://dx.doi.org/10.1136/bmjopen-2014-007302
38. Sudan M, Kheifets L, Arah O, Olsen J, Zeltzer L. Prenatal and Postnatal Cell Phone Exposures and Headaches in Children. Open Pediatr Med J. 2012;692012):46-52. http://dx.doi.org/10.2174/1874309901206010046
39. Zheng F, Gao P, He M, Li M, Wang C, Zeng Q, et al. Association between mobile phone use and inattention in 7102 Chinese adolescents: a population-based cross-sectional study. BMC Public Health. 2014; 4:1022. http://dx.doi.org/10.1186/1471-2458-14-1022
40. Raine S, Twomey L. Posture of the head. shoulders and thoracic spine in comfortable erect standing. Aust J Physiother. 1994;40(1):25-32. http://dx.doi.org/10.1016/S0004-9514(14)60451-7
2. Saunders TJ, Vallance JK. Screen time and health indicators among children and youth: Current evidence, limitations and future directions. Appl Health Econ Health Policy. 2017;15(3):323-31. https://doi.org/10.1007/s40258-016-0289-3
3. Barbosa Filho VC, Campos W, Lopes AS. Epidemiology of physical inactivity, sedentary behaviors, and unhealthy eating habits among Brazilian adolescents: a systematic review. Cienc Saude Coletiva. 2014;19(1):173-93. http://dx.doi.org/10.1590/1413-81232014191.0446
4. Torsheim T, Eriksson L, Schnohr CW, Hansen F, Bjarnason T, Valimaa R. Screen-based activities and physical complaints among adolescents from the Nordic countries. BMC Public Health. 2010;10:324. http://dx.doi.org/10.1186/1471-2458-10-324
5. International Headache Society (HIS). Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders. 3nd ed. Cephalalgia. 2018;38(1):1-211. http://dx.doi.org/10.1177/0333102417738202
6. Gu X, Xie Y. Migraine attacks among medical students in Soochow University, Southeast China: a cross-sectional study. J Pain Res. 2018;12(11):771-81. https://doi.org/10.2147/JPR.S156227
7. Kurt S, Kaplan Y. Epidemiological and clinical characteristics of headache in university students. Clin Neurol Neurosurg. 2008;110(1):46-50. http://dx.doi.org/10.1016/j.clineuro.2007.09.001
8. Farhadi Z, Alidoost S, Behzadifar M, Mohammadibakhsh R, Khodadadi N, Razieh Sepehrian, et al. The Prevalence of Migraine in Iran: A Systematic Review and Meta-Analysis. Iran Red Crescent Med J. 2016;18(10):e40061. https://doi.org/ 10.5812/ircmj.40061
9. Desouky DE, Zaid HA, Taha A. Migraine, tension-type headache, and depression among Saudi female students in Taif University. J Egypt Public Health Assoc. 2019;94(1):7. https://doi.org/10.1186/s42506-019-0008-7
10. Domingues RB, Aquino CCH, Santos JG, Silva ALP, Kuster GW. Prevalência impacto da cefaleia entre pomeranos do interior do Espírito Santo. Arq Neuropsiquiatr. 2006;64(4):954-7. http://dx.doi.org/10.1590/S0004-282X2006000600013
11. Pahim LS, Menezes AMB, Lima R. Prevalência e fatores associados à enxaqueca na população adulta de Pelotas, RS. Rev Saúde Pública. 2006;40(4):692-8. http://dx.doi.org/10.1590/S0034-89102006000500020
12. Pessigatti BP, Rodrigues APC, Aguiar PV, Dias FM. Aspectos biopsicossociais da saúde de estudantes e funcionários de uma instituição de ensino superior portadores de cefaleia. BrJP. 2020;3(1):19-24. https://doi.org/10.5935/2595-0118.20200005
13. Cho YM, Lim HJ, Jang H, Kim K, Choi JW, Shin C, et al. A cross-sectional study of the association between mobile phone use and symptoms of ill health. Environ Health Toxicol. 2016;31:e2016022. http://dx.doi.org/10.5620/eht.e2016022
14. Demirci S, Demirci K, Akgonul M. Headache in smartphone users: a cross-sectional study. J Neurol Psychol. 2016;4(1):5.
15. Messali A, Sanderson JC, Blumenfeld AM, Goadsby PJ, Buse DC, Varon SF, et al. Direct and Indirect Costs of Chronic and Episodic Migraine in the United States: A Web-Based Survey. Headache. 2016;56(2):306-22. https://doi.org/10.1111/head.12755
16. Stovner LJ, Andrée C; On behalf of the Eurolight Steering Committee. Impact of headache in Europe: a review for the Eurolight project. J Headache Pain. 2008;9(3):139-46. http://dx.doi.org/10.1007/s10194-008-0038-6
17. De Vitta A, Trize DM, Fiorelli A, Carnaz L, De Conti MHS, Simeão SFAP. Neck/shoulders pain and its relation to the use of tv/computer/videogame and physical activity in school students from Bauru. Fisioter Mov. 2014;27(1):111-18. http://dx.doi.org/10.1590/0103-5150.027.001.AO12
18. Fernandes JAA, Genebra CVS, Maciel NM, Fiorelli A, Conti MHS, De Vitta A. Low back pain in schoolchildren: a cross-sectional study in a western city of São Paulo state, Brazil. Acta Ortop Bras. 2015;23(5):235-8. http://dx.doi.org/10.1590/1413-785220152305148842
19. Bento TPF, Cornelio GP, Perrucini PO, Simeão SFAP, De Conti MHS, De Vitta A. Low back pain in adolescents and association with sociodemographic factors, electronic devices, physical activity and mental health. J Pediatr. 2019;S0021-7557(19)30279-7. http://dx.doi.org/10.1016/j.jped.2019.07.008
20. Subcomitê de Classificação Internacional das Cefaleias (CIC). Classificação Internacional das Cefaleias. 2 ed. São Paulo: Alaúde, 2006.
21. Falavigna A, Teles AR, Velho MC, Vedana VM, Silva RC, Mazzocchin T, et al. Prevalence and impact of headache in undergraduate students in Southern Brazil. Arq Neuro-Psiquiatr. 2010;68(6):873-7. http://dx.doi.org/10.1590/S0004-282X2010000600008
22. Birru EM, Abay Z, Abdelwuhab M, Basazn A, Sirak B, Teni FS. Management of headache and associated factors among undergraduate medicine and health science students of University of Gondar, North West Ethiopia. J Headache Pain. 2016;17:56. http://dx.doi.org/10.1186/s10194-016-0647-4
23. Almesned IS, Alqahtani NG, Alarifi JA, Alsaawy TN, Agha S, Alhumaid MA. Prevalence of primary headache among medical students at king Saud bin Abdulaziz University for health sciences, Riyadh, Saudi Arabia. J Fam Med Prim Care. 2018;7(6):1193-6. http://dx.doi.org/10.1186/s10194-020-1074-0
24. Schroeder RA, Brandes J, Buse DC, et al. Sex and Gender Differences in Migraine-Evaluating Knowledge Gaps. J Womens Health (Larchmt). 2018;27(8):965-73. https://doi.org/10.1089/jwh.2018.7274
25. Vetvik KG, MacGregor EA. Sex differences in the epidemiology, clinical features, and pathophysiology of migraine. Lancet Neurol. 2017;16(1):76-87. https://doi.org/10.1016/S1474-4422(16)30293-9
26. Pavlovic JM, Akcali D, Bolay H, Bernstein C, Maleki N. Sex-related influences in migraine. J Neurosci Res. 2017;95(1-2):587-93. https://doi.org/10.1002/jnr.23903
27. Todd C, Lagman-Bartolome AM, Lay C. Women and migraine: the role of hormones. Curr Neurol Neurosci Rep. 2018;18(7):42. https://doi.org/10.1007/s11910-018-0845-3
28. Scher AI, Stewart WF, Liberman J, Lipton RB. Prevalence of frequent headache in a population sample. Headache. 1998;38(7):497-506. http://dx.doi.org/10.1046/j.1526-4610.1998.3807497.x
29. Lipton RB, Munjal S, Alam A, Buse DC, Fanning KM, Reed ML, et al. Migraine in America Symptoms and Treatment (MAST) Study: Baseline Study Methods, Treatment Patterns, and Gender Differences. Headache. 2018;58(9):1408-26. https://doi.org/10.1111/head.13407
30. Anderson RJ, Jackson BL. Human platelet phenol sulfotransferase: stability of two forms of the enzyme with time and presence of racial difference. Clin Chim Acta. 1984;138(2):185-96. http://dx.doi.org/10.1016/0009-8981(84)90233-x
31. Winter AC, Berger K, Buring JE, Kurth T. Associations of socioeconomic status with migraine and non-migraine headache. Cephalalgia. 2012;32(2):159-70. http://dx.doi.org/10.1177/0333102411430854
32. Kandil MR, Hamed SA, Fadel KA, Khalifa HE, Ghanem MK, Mohamed KO. Migraine in Assiut Governorate, Egypt: epidemiology, risk factors, comorbid conditions and predictors of change from episodic to chronic migraine. Neurol Res. 2016;38(3):232-41. https://doi.org/10.1080/01616412.2015.1114232
33. Lipton RB, Stewart WF, Celentano DD, Reed ML. Undiagnosed migraine headaches. A comparison of symptom-based and reported physician diagnosis. Celphalagia. 1992;152(6):1273-8. http://dx.doi.org/10.1001/archinte.152.6.1273
34. Montagni I, Guichard E, Carpenet C, Tzourio C, Kurth T. Screen time exposure and reporting of headaches in young adults: a cross-sectional study. Cephalgia. 2016; 36(11):1020-27. http://dx.doi.org/10.1177/0333102415620286
35. Szyjkowska A, Gadzicka E, Szymczak W, Bortkiewicz A. The risk of subjective symptoms in mobile phone users in Poland - an epidemiological study. Int J Occup Med Environ Health. 2014;27(2):293-303. http://dx.doi.org/10.2478/s13382-014-0260-1
36. Stalin P, Abraham SB, Kanimozhy K, Prasad RV, Singh Z, Purty AJ. Mobile Phone Usage and its Health Effects Among Adults in a Semi-Urban Area of Southern India. J Clin Diagn Res. 2016;10(1):LC14-16. http://dx.doi.org/10.7860/JCDR/2016/16576.7074
37. Zheng F, Gao P, He M, Li M, Tan J, Chen D, et al. Association between mobile phone use and self-reported well-being in children: a questionnaire-based cross-sectional study in Chongqing, China. BMJ Open. 2014;5(5):e007302. http://dx.doi.org/10.1136/bmjopen-2014-007302
38. Sudan M, Kheifets L, Arah O, Olsen J, Zeltzer L. Prenatal and Postnatal Cell Phone Exposures and Headaches in Children. Open Pediatr Med J. 2012;692012):46-52. http://dx.doi.org/10.2174/1874309901206010046
39. Zheng F, Gao P, He M, Li M, Wang C, Zeng Q, et al. Association between mobile phone use and inattention in 7102 Chinese adolescents: a population-based cross-sectional study. BMC Public Health. 2014; 4:1022. http://dx.doi.org/10.1186/1471-2458-14-1022
40. Raine S, Twomey L. Posture of the head. shoulders and thoracic spine in comfortable erect standing. Aust J Physiother. 1994;40(1):25-32. http://dx.doi.org/10.1016/S0004-9514(14)60451-7