Assessment of headache characteristics in a general adolescent population: a comparison between retrospective interviews and prospective diary recordings

BACKGROUND: Reliable information on headache characteristics, including frequency and intensity, headache-associated impairment, and use of analgesic medications, may depend on the assessment method used. This study analyzed the correlations between headache characteristics determined in structured interviews and those determined in prospective diary recordings kept by adolescents in the general population. METHODS: In this cross-sectional school-based study, a representative sample of 488 adolescents aged 12–18 years were interviewed about headaches experienced during the previous year. Headache diaries for a three-week period were kept by 393 participants: 244 girls (62 %) and 149 (38 %) boys. RESULTS: Most adolescents (88 %) who reported headaches during their interview also recorded headaches in their diary. In contrast, 51 % of those who reported being headache-free during the last year recorded headaches in their diary. In the interviews, frequent headaches (at least 50 % of days during the last year) were reported by 2.9 % of participants, while 25.5 % reported this headache frequency in their diary. Overall, the ratings of headache frequency were significantly higher in diaries than in interviews (p < 0.001). Significant but low correlations were observed between intensity levels reported retrospectively and prospectively (rho = 0.28; p < 0.001) and between average scores of headache-related impairment reported retrospectively and prospectively (rho = 0.35; p < 0.001). The use of medications by those who reported one or more current headache disorder during their interview was significantly lower in prospective recordings than in the retrospective interview estimates (p < 0.001). CONCLUSIONS: There is inconsistency in the estimates of headache characteristics between retrospective reports and diary recordings. A comprehensive picture of headache complaints among adolescents may be better obtained through a combination of prospective diary recordings and interviews by school health and clinical services.