Chronic Frequent Headache in the General Population: Prevalence and Associated Factors

Abstract

We studied the nature and extent of comorbidity of chronic frequent headache (CFH) in the general population and the influence of CFH and comorbidity on quality of life. Subjects with CFH (headache on >14 days/month) were identified in a general health survey. We sent a second questionnaire including questions on comorbidity and quality of life to subjects with CFH and subjects with infrequent headache (IH) (1-4 days/month). We recoded comorbidity by using the Cumulative Illness Rating Scale (CIRS) and measured quality of life with the RAND-36, a Dutch version of Short Form-36. CFH subjects (n = 176) had higher comorbidity scores than the IH subjects (n = 141). Mean CIRS scores were 2.94 for CFH and 1.55 for IH [mean difference 1.40, 95% confidence interval (CI) 0.91, 1.89]. The mean number of categories selected was 1.92 in CFH and 1.10 in IH (mean difference 0.82, 95% CI 0.54, 1.11). Fifty percent of CFH subjects had a comorbidity severity level of at least 2, indicating disorders requiring daily medication, compared with 28% of IH subjects (mean difference 22%, 95% CI 12, 33). CFH subjects had more musculoskeletal, gastrointestinal, psychiatric and endocrine/breast pathology than IH subjects. Quality of life in CFH subjects was lower than that of IH subjects in all domains of the RAND-36. Both headache frequency and CIRS score had a negative influence on all domains. We conclude that patients with CFH have more comorbid disorders than patients with infrequent headaches. Many CFH patients have a comorbid chronic condition requiring daily medication. Both high headache frequency and comorbidity contribute to the low quality of life in these patients. ᮀ Chronic daily headache, comorbidity, headache, medication overuse, quality of life

The pain of low status: the relationship between subjective socio-economic status and analgesic prescriptions in a Scottish community sample

“…Generally, research supports the former hypothesis (e.g., Wiendels et al, 2006;Hagen et al, 2002), and we agree in the context of the SSS-pain relationship. However, a longitudinal design is required to draw firm conclusions, and we hope Wave 2 will enable this.…”

Headache Diagnosis in Primary Care

“…Data were analysed using non-parametric tests for categorical variables, and with t-tests for continuous data where differences were compared between diagnostic groups. Statistical methods are described in details elsewhere [18].…”

“…In another family practice study, Weindels et al found that compared to patients with less frequent headache episodes, a group with frequent headaches (≥ 15 days per month) were significantly more likely to have somatic problems, like gastroenterological and musculoskeletal disorders [18], as well as more psychiatric disorders and medication over-use [19]. Both frequent headache and comorbidity were associated with lower quality of life [19].…”

Combination of acupuncture and spinal manipulative therapy: management of a 32-year-old patient with chronic tension-type headache and migraine

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“…26 Most notably, the headache worsens during the period of medication overuse. 18,19,21,23 What differentiates the quality of MOHs from CTTHs most clearly is that MOHs worsen significantly with mental or physical exertion, whereas CTTHs do not. Medication overuse headaches occur in approximately 1% of the population 28 and can be a major contributing factor in the transformation of episodic headaches to CDHs.…”