Aim: To determine the role of headache as a marker of psychological and somatic distress in children with non-psychotic mental disorders (NPMD), with a focus on its relationship with conflicts in the family and school environment. Materials and Methods: A retrospective analysis was performed on medical records of 168 children aged 8–10 years who were under observation by child psychiatrists. According to ICD-10 diagnostic criteria, the cohort was divided into four subgroups: neurotic disorders (ND; n = 42), neurosis-like disorders (NSD; n = 46), emotional and behavioural disorders (EBD; n = 45), and developmental disorders of school skills (DSS; n = 35). Clinical complaints including headache, anxiety, sleep disturbances, learning difficulties, behavioural dysregulation, and interpersonal conflicts were analysed. The associations between binary variables were assessed using the phi (.) coefficien Results: Headache was reported by 41% of children with ND, 60% with NSD, 36% with EBD, and 29% with DSS. In ND and NSD, headache was combined with anxiety, sleep problems, and cognitive deficits, whereas in EBD and DSS, it was more closely associated with interpersonal conflicts and school maladaptation. We revealed moderate-to-relatively strong associations between headache and conflicts with parents (. = 0,28–0,48), as well as with teachers (. = 0,33–0,46), indicating that headache may reflect relational distress. Conclusions: Headache in children with NPMD serves as a clinically relevant psychosomatic marker that integrates biological, emotional, and social dimensions of maladaptation. Recognition of headache as an indicator of psychological suffering highlights the importance of integrative, family-centred, and ethically sensitive approaches to diagnosis and treatment.