The Impact of Social Anxiety on Adolescents Diagnosed With Primary Headache: A Case-control Study

The study will include adolescents aged 12-18 years who have been diagnosed with primary headachebased on the International Classification of Headache Disorders, 3rd edition (ICHD-3). The main exposure ofinterest will be the presence and severity of social anxiety, which will be measured using the Social AnxietyScale for Adolescents (SAS-A), a validated self-report questionnaire. The SAS-A takes approximately 10minutes to complete. Additional variables that will be collected will include sociodemographiccharacteristics, BMI, parental education levels, income status, parental smoking habits, and theadolescent's exposure to secondhand and thirdhand tobacco smoke. All assessments, includingquestionnaires and physical measurements (height and weight), are expected to be completed inapproximately 20 minutes per participant. The total observation duration for each participant will be about30 minutes.

Inclusion criteria

• Adolescents aged 12-18 years
• Case group: Participants who will be diagnosed with primary headache according to InternationalClassification of Headache Disorders, 3rd edition (ICHD-3) criteria, confirmed by a pediatric neurologist
• Control group: Participants who will have no history of recurrent headache or chronic physical/psychiatricillness

Exclusion criteria

• History of neurological disease other than primary headache
• Any previously diagnosed psychiatric disorders
• Regular use of psychotropic medications
• Cognitive or developmental disabilities that would interfere with assessments