The relationship between gender, peer victimization, mental health, and frequent headaches in adolescents: A Canadian population-based observational study (P14-12.002)

<h3>Objective:</h3> To assess the association between gender, peer victimization, mental health and frequent headaches in adolescents. <h3>Background:</h3> Little is known about the relationship between gender, peer victimization and headaches in adolescents. <h3>Design/Methods:</h3> This was an observational study of adolescents aged 12–17 using data from a population-based health survey (2019 Canadian Health Survey on Children and Youth). Headache frequency was dichotomized as ‘about once a week or less’ or ‘&gt;once a week’ (defined as frequent recurrent headaches). Logistic regression was used to quantify the association between gender, peer victimization (overt or relational and occurring ≥monthly), suicidality, and the odds of frequent headaches, unadjusted and adjusted for age and sex. The final model included all exposures and controlled for age, sex, household income, and presence of mood and anxiety disorder. Bootstrap replicate weighting was used to account for survey design effects. <h3>Results:</h3> There were 2,268,840 participants (weighted sample size) (mean age 14.4, 48.8% females, 0.5% transgender) and 11.2% reported frequent headaches. Age and female sex were associated with frequent headaches (OR=1.26, 95%CI=1.20–1.31, and OR=2.89, 95%CI=2.47–3.37, respectively), as was transgender status (OR=3.30, 95%CI=1.64–6.63, adjusted for age/sex). Youth with frequent headaches had higher odds of experiencing both overt and relational peer victimization compared to peers (OR=2.69, 95%CI=2.31–3.14, and OR=3.03, 95%CI=2.58–3.54, adjusted for age/sex). In the final full model, transgender status was no longer significant, though frequent headaches were significantly associated with overt and relational peer victimization (OR=1.82, 95%CI=1.41–2.34, and OR=1.54, 95%CI=1.17–2.03, respectively), suicidality (OR=1.83, 95%CI=1.44–2.32), and having a mood or anxiety disorder (OR=1.50, 95%CI=1.01–2.21, and OR=1.74, 95%CI=1.24–2.45, respectively). <h3>Conclusions:</h3> Overt and relational peer victimization, transgender status, suicidality, and having a mood or anxiety disorder were significantly associated with frequent headaches in a large sample of adolescents. After controlling for peer victimization, suicidality, and having a mood or anxiety disorder, the association between transgender status and frequent headaches disappeared. <b>Disclosure:</b> Ms. Nilles has received research support from French Gilles de la Tourette Association. Ms. Nilles has received research support from Owerko Centre of Alberta Children’s Hospital Research Institute. Ms. Nilles has received research support from Assistance Publique - Hôpitaux de Paris. Jeanne Williams has nothing to disclose. Dr. Patten has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Canadian Psychiatric Association. Dr. Patten has received publishing royalties from a publication relating to health care. The institution of Dr. Pringsheim has received research support from Maternal Newborn Child and Youth Strategic Clinical Network. The institution of Dr. Pringsheim has received research support from Owerko Center of Alberta Children’s Hospital Research Institute. The institution of Dr. Pringsheim has received research support from Canadian Institutes of Health Research. The institution of Dr. Pringsheim has received research support from Public Health Agency of Canada. The institution of Dr. Orr has received research support from Alberta Children’s Hospital Research Institute. The institution of Dr. Orr has received research support from Canadian Institutes of Health Research. Dr. Orr has received publishing royalties from a publication relating to health care. Dr. Orr has a non-compensated relationship as a Associate Editor with Headache: The Journal of Head and Face Pain that is relevant to AAN interests or activities. Dr. Orr has a non-compensated relationship as a Editorial Board with Neurology that is relevant to AAN interests or activities.