Headache in adolescents in Dutch general practice

We set out to describe the occurrence of headache in adolescents in general practice, the diagnoses made, the referrals to specialised care and the role of psychosocial problems in idiopathic headache. Data from the Dutch national survey of morbidity and interventions in general practice were used. The practice population (103 practices) comprised 37,187 children aged 12-18 years. In 650 episodes headache was a reason for encounter. The incidence of headache as presented to the GP was 69.9 per 1000 person years. The incidence in girls was twice as high as in boys. Half of the episodes with headache complaints were related to an infectious disease. The incidence rate of idiopathic headache was 18.0 per 1000 person years. Eight percent of all headache episodes were diagnosed as a psychosocial problem. Of all episodes, 25% percent were diagnosed as idiopathic headache (i.e. headache as symptom diagnosis, tension headache or migraine). Of these episodes, 21% were associated with an underlying psychosocial problem. Referrals were made by the GP in three percent of all headache episodes and four percent of idiopathic headache episodes. Headache in adolescents is a common reason for visiting a general practice. The symptom is often associated with an infectious disease. The GP is aware of underlying psychosocial problems. Only few children are referred for specialist care.