Symptoms of Obsessive-Compulsive Disorder, Attention-Deficit/Hyperactivity Disorder, and Autism Spectrum Disorder in Children and Adolescents Attending a Headache Outpatient Clinic and School-Based Controls

This case-control study assessed symptom severity and prevalence of obsessive-compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) in children attending a headache clinic compared to controls. We included 343 patients (5-19 years) and 130 controls (6-19 years; no prior headache diagnosis/medical contact for headache) between October 2018 and January 2024. Controls were divided into CH+ (experiencing headaches) and CH- (headache-free). Severity was assessed using scores from questionnaires, and prevalence was defined by prior diagnosis or symptom scores above clinical cutoffs, therefore indicating symptom burden over confirmed diagnoses. Patients had more severe symptoms of OCD, ADHD, and ASD than CH-. CH+ had the most severe symptoms of OCD and ADHD. OCD, ADHD, and ASD research diagnoses were present in 20.8%, 17.3%, and 10.1% in patients; 27.8%, 18.8%, and 4.4% in CH+; 1.7%, 7.0%, and 1.8% in CH-. Headache in youth, even in non-clinical settings, is linked to psychiatric symptoms; hence, routine screening is recommended.