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From the Department of Neurology (S.-J.W., J.-L.F.), National Yang-Ming University School of Medicine, Neurological Institute (S.-J.W., J.-L.F.), Taipei Veterans General Hospital, and Department of Psychiatry (K.-D.J.), Buddhist Tzu Chi General Hospital and Tzu Chi University School of Medicine, Hualian, Taipei, and Department of Neurology (S.-R.L.), Kaohsiung Medical University Chung-Ho Memorial Hospital, Taiwan.
Address correspondence and reprint requests to Dr. S.-J. Wang, Neurological Institute, Taipei Veterans General Hospital, Taipei, 112, Taiwan; e-mail: sjwang{at}vghtpe.gov.tw
Objectives: To assess the outcomes and predictors of chronic daily headache (CDH) in a community-based cohort of adolescents.
Methods: We established a field sample of 122 adolescents (32 M/90 F, ages 12 to 14) with CDH in 2000. These adolescents received annual follow-up by neurologists for 2 years via a semistructured telephone interview. CDH was defined as 
15 headache days/month, average 2 h/day for >3 months; subtypes were classified based on the original and appendix criteria of the International Classification of Headache Disorders (2nd ed.; ICHD-2). Poor outcome was defined as persistence of CDH at 2 years.
Results: Follow-up response rates were 92% in 2001 and 84% in 2002. Average monthly headache frequency was 11.0 ± 9.7 days in 2001 and 7.7 ± 6.5 days in 2002. CDH persistence rates were 40% in 2001 and 25% in 2002. Medication overuse declined from 20% (baseline) to 6% at 2 years. The prevalence of migraine did not change throughout the follow-up (67 to 60%), whereas that of tension-type headache deceased from 86 to 46% (p < 0.001). Chronic migraine prevalence increased markedly at baseline and became the most common CDH subtype at follow-up when using the ICHD-2 appendix criteria. During follow-up, seven subjects (6%) dropped out of school. Independent predictors for CDH persistence were medication overuse and major depression.
Conclusions: Most adolescents with chronic daily headache (CDH) continued to have frequent headaches, although the incidence of CDH declined at follow-up. Migraine diagnosis gained prominence as headache frequency decreased. The percentages of chronic migraine in adolescents with CDH increased obviously if the appendix criteria were applied.
This article was previously published in electronic format as an Expedited E-Pub on December 20, 2006, at www.neurology.org.
Supported by grants from the National Science Council (NSC 89-2314-B-010-032) and Taipei Veterans General Hospital (VGH-295).
Disclosure: The authors report no conflicts of interest.
Received March 28, 2006. Accepted in final form November 2, 2006.
This article has been cited by other articles:
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  S.-J. Wang, J.-L. Fuh, and S.-R. Lu Chronic daily headache in adolescents: An 8-year follow-up study Neurology, August 11, 2009; 73(6): 416 - 422. [Abstract] [Full Text] [PDF]
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 Persistence of Chronic Daily Headache in Adolescents Journal Watch Neurology, July 17, 2007; 2007(717): 3 - 3. [Full Text]
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 J. G. Millichap Outcome of Chronic Daily Headache in Adolescents AAP Grand Rounds, June 1, 2007; 17(6): 68 - 68. [Full Text] [PDF]
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