People who have experienced traumatic events in childhood such as abuse, neglect or household dysfunction may be more likely to experience headache disorders as adults, according to a meta-analysis published in the October 25, 2023, online issue of Neurology®, the medical journal of the American Academy of Neurology. This research does not prove that such experiences cause headaches; it only shows an association.
Traumatic events in childhood can have serious health implications later in life. Our meta-analysis confirms that childhood traumatic events are important risk factors for headache disorders in adulthood, including migraine, tension headaches, cluster headaches, and chronic or severe headaches. This is a risk factor that we cannot ignore."
Catherine Kreatsoulas, PhD, study author, Harvard T.H. Chan School of Public Health in Boston, Massachusetts
The meta-analysis involved 28 studies, including 154,739 participants across 19 countries.
Of the total participants, 48,625 people, or 31%, reported at least one traumatic childhood event, and 24,956 people, or 16%, were diagnosed with primary headaches. Among participants with at least one traumatic childhood event, 26% were diagnosed with a primary headache disorder, compared to 12% of participants that had no traumatic childhood events.
Researchers found that people who had experienced one or more traumatic childhood events were 48% more likely to have headache disorders than those who had not experienced such traumatic events.
They also found that as the number of traumatic childhood events increased, the odds of having headaches also increased. When compared to people who have not experienced childhood trauma, people who had experienced one type of traumatic event had a 24% increased risk of a headache disorder, while people who had experienced four or more types of traumatic events were more than twice as likely to have a headache disorder.
Researchers also looked at the association between types of traumatic childhood events. Events categorized as threat traumas included physical abuse, sexual abuse, emotional abuse, witnessing and/or threat of violence, or serious family conflicts. Events categorized as deprivation traumas included neglect, economic adversities, having an incarcerated household member, divorce or separation, parental death, and living in a household with mental illness, chronic disability or disease, or alcohol or substance abuse.
They found that threat traumas were linked to a 46% increase in headaches and deprivation traumas were linked to a 35% increase in headaches. Among the top types of threat traumas, experiencing physical and sexual abuse was linked to a 60% increased risk for headaches; among deprivation traumas, those who experienced neglect in childhood had an almost three-fold increased risk for headache disorders.
"This meta-analysis highlights that childhood traumatic events categorized as threat or deprivation traumas are important and independent risk factors for headache disorders in adulthood," said Kreatsoulas. "Identifying the specific types of childhood experiences may help guide prevention and treatment strategies for one of the leading disabling disorders worldwide. A comprehensive public health plan and clinical intervention strategies are needed to address these underlying traumatic childhood events."
"It is important to note that the true estimate of the association is likely higher due to the sensitive nature of reporting childhood traumatic events," Kreatsoulas added.
Sikorski, C., et al. (2023). Adverse Childhood Experiences and Primary Headache Disorders: A Systematic Review, Meta-analysis, and Application of a Biological Theory. Neurology. doi.org/10.1212/WNL.0000000000207910.