Abstract
BackgroundAlthough mostly mild in symptom severity, tension-type headache (TTH) can cause disability. However, factors associated with disability of TTH have been rarely reported. This study sought to assess the factors associated with TTH-related disability and impact.MethodsWe analyzed data form the Korean Headache Survey, a nation-wide survey regarding headache in all Korean adults aged 19–69 years. TTH-related disability was measured by surveying actual disability and Headache Impact Test-6 (HIT-6). Actual disability was defined as having one or more days of activity restriction or missed activity due to headache in the last 3 months. The HIT-6 score ≥ 50 was regarded as significant headache impact associated with TTH. We assessed factors associated with TTH-related disability and impact using logistic regression analyses adjusting for sociodemographic variables and headache characteristics.ResultsAmong 1507 individuals, the 1-year prevalence rate of TTH was 30.7% (n = 463), of which 4.8% reported actual disability and 21.3% had headache impact, respectively. In univariate analyses, sociodemographic variables were not associated with actual disability and headache impact, respectively. There were relationships between several headache characteristics and actual disability/headache impact. After adjustment of potential confounders, moderate headache intensity was correlated with actual disability (odds ratio [OR]: 4.41, 95% confidence interval [CI]: 1.46–13.27), while an inverse association was observed between no aggravation by routine activity and actual disability (OR: 0.32, 95% CI: 0.12–0.88). Multivariate analyses showed that ORs for headache impact were increased in those with higher headache frequency (OR: 2.54, 95% CI: 1.47–4.39 for 1–14 days/month; OR: 23.83, 95% CI: 5.46–104.03 for ≥ 15 days/month), longer headache time duration (OR: 1.84, 95% CI: 1.04–3.25 for ≥ 1 and < 4 hours; OR: 2.44 95% CI: 1.17–5.11 for ≥ 4 hours), and phonophobia (OR: 1.73, 95% CI: 1.02–2.95), whereas decreased in those with no aggravation by routine activity (OR: 0.32, 95% CI: 0.12–0.88).ConclusionsSeveral headache characteristics were associated with actual disability and headache impact among TTH individuals. Our findings suggest that there needs to be consideration careful of troublesome headache characteristics for TTH individuals suffering from disability and impact.
Highlights
Mostly mild in symptom severity, tension-type headache (TTH) can cause disability
In this Korean population-based study, we evaluated factors associated with TTH-related disability, in terms of actual disability and headache impact, respectively
Given the considerable medical and social cost caused by primary headache, TTH constitute a major public health concern [27,28]
Summary
Mostly mild in symptom severity, tension-type headache (TTH) can cause disability. TTH refers to a vague and heterogeneous headache syndrome; it is generally characterized by the absence of migrainous features as essential general diagnostic criteria, and its exact pathogenesis is still unknown [3,4]. For this reason, TTH has been given much less attention from health professionals and researchers, and there is a relative lack of epidemiological and clinical data on TTH, so far. The number of work days missed due to TTH was three times higher than that of migraine in previous Danish studies [6,7] These data imply that the impact and disability caused by TTH are not always mild, contrary to its defining features
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