One-year prevalence and the impact of migraine and tension-type headache in Turkey: a nationwide home-based study in adults

Abstract

Several studies have shown that the prevalence of migraine and tension-type headache (TTH) varied between different geographical regions. Therefore, there is a need of a nationwide prevalence study for headache in our country, located between Asia and Europe. This nationwide study was designed to estimate the 1-year prevalence of migraine and TTH and analyse the clinical features, the impact as well as the demographic and socio-economic characteristics of the participant households in Turkey. We planned to investigate 6,000 representative households in 21 cities of Turkey; and a total of 5,323 households (response rate of 89%) aged between 18 and 65 years were examined for headache by 33 trained physicians at home on the basis of the diagnostic criteria of the second edition of the International Classification of Headache Disorders (ICHD-II). The electronically registered questionnaire was based on the headache features, the associated symptoms, demographic and socio-economic situation and history. Of 5,323 participants (48.8% women; mean age 35.9 ± 12 years) 44.6% reported recurrent headaches during the last 1 year and 871 were diagnosed with migraine at a prevalence rate of 16.4% (8.5% in men and 24.6% in women), whereas only 270 were diagnosed with TTH at a prevalence rate of 5.1% (5.7% in men and 4.5% in women). The 1-year prevalence of probable migraine was 12.4% and probable TTH was 9.5% additionally. The rate of migraine with aura among migraineurs was 21.5%. The prevalence of migraine was highest among 35–40-year-old women while there were no differences in age groups among men and in TTH overall. More than 2/3 of migraineurs had ever consulted a physician whereas only 1/3 of patients with TTH had ever consulted a physician. For women, the migraine prevalence was higher among the ones with a lower income, while among men, it did not show any change by income. Migraine prevalence was lower in those with a lower educational status compared to those with a high educational status. Chronic daily headache was present in 3.3% and the prevalence of medication overuse headache was 2.1% in our population. There was an important impact of migraine with a monthly frequency of 5.9 ± 6, and an attack duration of 35.1 ± 72 h, but only 4.9% were on prophylactic treatment. The one-year prevalence of migraine estimated as 16.4% was similar or even higher than world-wide reported migraine prevalence figures and identical to a previous nation-wide study conducted in 1998, whereas the TTH prevalence was much lower using the same methodology with the ICHD-II criteria.Electronic supplementary materialThe online version of this article (doi:10.1007/s10194-011-0414-5) contains supplementary material, which is available to authorized users.

Prevalence of tension-type headache in adult general population: the PACE study and review of the literature

“…The crude past-year prevalence of dTTH in Parma's adult general population was 19.4 %, without differences in sex distribution. In European countries, the past-year prevalence of dTTH ranges from 5.1 % in Eastern Europe [8] to 74.0 % in Western Europe [9]. Our results are in agreement with those of Vukovic et al, who in Croatia found a dTTH prevalence of 21.2 %, 23.2 % in women and 19.1 % in men [10].…”

Presence of Headache and Migraine in Asthma Patients

“…Martin et al [8] reported the rate of chronic migraine to be 5.4% in patients diagnosed with asthma. In a study conducted in Turkey on the prevalence of migraine, migraine was detected in 16.4% of the population (24.6% in females and 8.5% in males) [9]. This shows that migraine-type headache can be more commonly seen in asthma patients than in the normal population.…”

Tension-Type Headache: A Life-Course Review

“…Findings show that, after examination by a physician, 35.6% of patients remained unclassified [27], one-third of TTH patients were misdiagnosed with sinusitis, followed by other misdiagnoses such as hypertensive or cervicogenic headache, [28] and as few as 1.3% of patients obtained a correct diagnosis of TTH [28]. The lack of specific markers of tension-type headache presents a substantial challenge in differential diagnosis of IHSdefined TTH and migraine due to the overlap of symptoms and precipitants of each headache type [12,29,30].…”