Prevalence and impact of tension-type headache among high school students of Hyderabad city: A cross-sectional study

Background: Tension-type headache (TTH) is a common yet underdiagnosed condition in adolescents, often triggered by academic stress and psychosocial factors. It affects quality of life (QOL), school performance, and social functioning. Despite its high global prevalence, recent data on TTH among Indian adolescents, especially in urban areas like Hyderabad, are scarce. Aims and Objectives: This study aims to assess the prevalence, characteristics, associated factors, and impact of TTH among high school students in Hyderabad. Materials and Methods: This cross-sectional study was conducted in four government high schools in urban Hyderabad. A total of 300 regularly attending students from grades 8 to 10 were selected using simple random sampling. TTH diagnosis was based on International Classification of Headache Disorders-3 criteria. Data were collected using a structured questionnaire, including headache impact test-6 and chronic headache QOL questionnaire. Analysis was done using the Statistical Package for the Social Sciences version 26 with descriptive and inferential statistics; significance was set at P≤0.05. Results: Among 300 students, TTH was diagnosed in 18.3%, with 12% having low-frequency episodic, 1.7% high-frequency episodic, and 4.7% chronic TTH. Chronic TTH was more prevalent in older, high school students. Headaches were mostly pressing, bilateral, and not aggravated by activity. Photophobia and phonophobia were common. Headache severity and frequency significantly impacted QOL and school attendance. No significant gender differences were found in TTH prevalence or impact scores. Conclusion: TTHs are prevalent among adolescents, particularly in high school, adversely affecting their QOL and academics. Early school-based screening, increased awareness, healthy lifestyle promotion, and stress management are vital for effective prevention and care.