Prevalence Of Headache Disorders Research Articles

The Prevalence of Headache Disorders in Children and Adolescents in Istanbul: A School-Based Study

BackgroundHeadache among children and adolescents is an important health problem. In this school-based epidemiological study conducted in Istanbul, we aimed to reveal the frequency of headaches in this population, define the risk factors associated with headaches, and establish the effect of headaches on the quality of life in this population. MethodsThe child and adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation structured questionnaire were conducted in 30 schools in Istanbul. The diagnosis was made based on the International Classification of Headache Disorders III-(ICHD-3) beta version. Risk factors associated with headaches were analyzed in a binary logistic regression model. ResultsAmong the 5944 students (boys = 3011 [50.7%], girls 2933 [49.3%]) who completed the survey and were enrolled in this study, 3354 (56.4%) reported a headache ever. The prevalence of headaches was significantly higher in girls (62.6% vs. 50.4%, P < 0.001). Migraine prevalence was found to be 5.2%, whereas tension-type headache (TTH) prevalence was 26.1%. Being a female, age, living on the European side, and headache history in the family were found to be associated with an increased risk of having a headache. Pupils with headaches reported that they missed an average of 0.5 ± 1.5 school days due to headaches. ConclusionTTH was found to be the most common headache syndrome in Istanbul metropolitan area. Considering the effect of headaches on school success and quality of life in childhood, it is clear that the correct diagnosis of headaches and careful handling of risk factors are crucial for this population.

Prevalence of headache disorders in patients living with epilepsy in rural region in western part of India

Background and aimsHeadache disorders cause significant distress in patients living with epilepsy (PWE) and are underreported. This study aimed to evaluate the prevalence of various forms of headache in PWE. MethodologyTwo hundred and three PWE were evaluated for the presence and type of headache as per the International Classification of Headache Disorders (ICHD)-3 classification criteria. The severity was graded using the Headache Under Response to Treatment (HURT)–3. A subgroup analysis of headache and epilepsy was done. The World Health Organization-5 (WHO-5) questionnaire was used to assess mental well-being. The Mini International Neuropsychiatric Interview (MINI) questionnaire was used to study the psychiatric comorbidities, which were classified according to the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV classification. ResultsThe prevalence of headaches in PWE was 45% [60% females]. Female gender and younger age were significantly associated with migraine (p values of 0.03 and 0.05, respectively). Migraine was the most common type of headache (71%), followed by tension-type headache (TTH) (23%) in PWE. The headache was inter-ictal in 80% of PWE. In PWE with migraine, both juvenile myoclonic epilepsy (JME) and frontal lobe epilepsy (FLE) had a 28% prevalence. In PWE with TTH, FLE was more common (43%). The prevalence of migralepsy in PWE was 4% [n = 4; 2 each of occipital lobe epilepsy (OLE) and idiopathic generalized epilepsy (IGE)]. A psychiatric illness was more than two times more likely in PWE with headache (n = 34; 37%) as compared to PWE without headache (n = 19; 17%). Patients living with epilepsy with headaches and psychiatric comorbidities had significantly lower mental well-being (p = 0.001). Forty five percent of PWE with headaches required acute management, and 35% required prophylactic management for their headache. ConclusionHeadache is frequently ignored in PWE. It can affect their mental health and quality of life. Evaluation and management of headache in PWE is very important.

Questionnaire-Based Survey during COVID-19 Vaccination on the Prevalence of Elderly's Migraine, Chronic Daily Headache, and Medication-Overuse Headache in One Japanese City-Itoigawa Hisui Study.

Background: The prevalence of headache disorders, migraine, chronic daily headache (CDH), and medication-overuse headache (MOH) among the elderly in Japan has not been sufficiently investigated. We performed a questionnaire-based survey and revealed 3-month headache prevalence and headaches’ characteristics. Methods: The population aged over 64 was investigated in Itoigawa during their third coronavirus disease 2019 vaccination. Migraine, MOH was defined as The International Classification of Headache Disorders Third edition. CDH was defined as a headache occurring at least 15 days per month. K-means++ were used to perform clustering. Results: Among 2858 valid responses, headache disorders, migraine, CDH, and MOH prevalence was 11.97%, 0.91%, 1.57%, and 0.70%, respectively. Combined-analgesic and non-opioid analgesic were widely used. Only one migraineur used prophylactic medication. We performed k-means++ to group the 332 MOH patients into four clusters. Cluster 1 seemed to have tension-type headache-like headache characteristics, cluster 2 seemed to have MOH-like headache characteristics, cluster 3 seemed to have severe headaches with comorbidities such as dyslipidemia, stroke, and depression, and cluster 4 seemed to have migraine-like headache characteristics with photophobia and phonophobia. Conclusions: This is the largest prevalence survey in the Japanese elderly. Headache disorders are still the elderly’s burden. Clustering suggested that severe headaches associated with some comorbidities may be unique to the elderly.

The prevalence of headache disorders in children and adolescents in Iran: a schools-based study.

While the Global Burden of Disease study reports headache disorders as the third-highest cause of disability worldwide, the headache data in this study largely come from adults. This national study in Iran, the first of its type in the Eastern Mediterranean Region, was part of a global schools-based programme within the Global Campaign against Headache contributing data from children (6-11 years) and adolescents (12-17 years). We followed the generic protocol for the global study. In a cross-sectional survey, self-completed structured questionnaires were administered to pupils within their classes in 121 schools selected from across the country to be representative of its diversities. Headache diagnostic questions were based on ICHD-3 criteria but for the inclusion of undifferentiated headache. Of 3,357 potential participants, 3,244 (children 1,308 [40.3%], adolescents 1,936 [59.7%]; males 1,531 [47.2%], females 1,713 [52.8%]) satisfactorily completed the questionnaire. Children and males were therefore somewhat under-represented, with a participating proportion of 96.6%. Gender- and age-adjusted 1-year prevalence of any headache was 65.4%, of migraine 25.2%, of tension-type headache 12.7%, of undifferentiated headache 22.1%, of all headache on ≥15 days/month 4.1%, and of probable medication-overuse headache 1.1%. All headache types except undifferentiated headache were more prevalent among adolescents than children; probable medication-overuse headache increased five-fold between childhood and adolescence. Headache disorders are common in children and adolescents in Iran, with undifferentiated headache accounting for over one third of cases. The increasing prevalence of probable medication-overuse headache with age is concerning. These findings are of importance to health and educational policies in Iran.

Headache disability, lifestyle factors, health perception, and mental disorder symptoms: a cross-sectional analysis of the 2013 National Health Survey in Brazil.

To evaluate the past 2-week headache disability and explore its association with lifestyle factors, health perception, and mental disorder symptoms in the PNS 2013 survey. The prevalence of headache disorders has been associated with lifestyle factors, mental disorders, and health perception. However, less is known regarding their influence on headache-related disability. In a cross-sectional analysis, chi-squared tests and logistic regression models computed the associations between headache-related disability (defined as days lost from work, school, or household chores in the past 2weeks) and the variables of interest, compared to other disease-related disabilities groups or no day lost group. The adjusted models controlled for the effects of age, sex, income, and educational levels. In the sample aged ≥ 18years (n = 145,580), 10,728 (7.4%) participants reported any disease-related disability in the past 2weeks (median interquartile range (IQR) for age = 47 (33-59) years, 62% women), with the median (IQR) days lost = 5 (2-14). Headache disability represented 5.3% (572/10,728) of all diseases, constituting the 4th most prevalent disease-related disability [median (IQR) days lost = 3 (3-4)]. Among people aged 18-25years, headache disorders ranked 2nd as the most prevalent disability (13%), headache-related disability positively associated with physical inactivity, poorer health perception, and frequent mental disorders symptoms, and negatively associated with overweight, obesity, and alcohol consumption. Headache disability represents a leading cause of disease-related disability in Brazil and associates with unhealthy lifestyle factors, poorer health perception, and frequent mental disorder symptoms.

The prevalence of headache disorders in children and adolescents in Mongolia: a nationwide schools-based study

BackgroundThe Global Campaign against Headache collects data from children (7–11 years) and adolescents (12–17 years) both to inform health and education policies and to contribute to the Global Burden of Disease (GBD) study. This survey in Mongolia was part of this global enquiry.MethodsFollowing the generic protocol for the global enquiry, this was a schools-based cross-sectional survey. Self-completed structured questionnaires were administered, within classes, in seven schools in four districts of the Capital city and three rural areas of Mongolia, selected to represent the country’s diversities. Headache diagnostic questions were based on ICHD-3 criteria but for the inclusion of undifferentiated headache (UdH).ResultsOf 4515 potential participants, 4266 completed the questionnaire (children 2241 [52.5%], adolescents 2025 [47.5%]; males 2107 [49.4%], females 2159 [50.6%]). Children were therefore slightly over-represented, although overall mean age was 11.3 ± 3.3 years (range: 6–17; median 11). The non-participation proportion was 4.5%. Observed lifetime prevalence of headache was 81.0%. Gender- and age-adjusted 1-year prevalence was 59.4% (migraine: 27.3%; tension-type headache [TTH]: 16.1%; UdH: 6.6%; all headache on ≥15 days/month: 4.2%; probable medication-overuse headache: 0.7%). All headache types except UdH were more prevalent among females than males, and all were more prevalent among adolescents than children, although UdH represented a higher proportion of all headache in children (13.0%) than in adolescents (10.0%). Headache yesterday was reported by 15.9% of the sample, 26.0% of those with headache.ConclusionsAt least in adolescents, headache in Mongolia is no less common than in adults. The clear difference from similar studies in other countries was a lower prevalence of UdH, perhaps a consequence of reporting bias in a non-troublesome headache (mild and short-lasting by definition). This study informs policy in Mongolia and, with no similar study yet from elsewhere in Western Pacific Region, makes an important contribution to the global enquiry.

The prevalence of headache disorders in children and adolescents in Ethiopia: a schools-based study

BackgroundThe Global Burden of Disease (GBD) study establishes headache as the second-highest cause of disability worldwide. Because most headache data in GBD are from adults, leading to underestimation of headache-attributed burden, a global schools-based programme within the Global Campaign against Headache is contributing data from children (7–11 years) and adolescents (12–17 years). This national study in Ethiopia is the first in this programme reported from sub-Saharan Africa.MethodsA cross-sectional survey following the generic protocol for the global study was conducted in six schools (urban and rural), in Addis Ababa city and three regions of Ethiopia. Structured questionnaires were self-completed under supervision by pupils within their classes. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH).ResultsOf 2349 potential participants, 2344 completed the questionnaire (1011 children [43.1%], 1333 adolescents [56.9%]; 1157 males [49.4%], 1187 females [50.6%]), a participation proportion of 99.8%. Gender- and age-adjusted 1-year prevalence of headache was 72.8% (migraine: 38.6%; tension-type headache: 19.9%; UdH: 12.3%; all headache on ≥15 days/month: 1.2%; probable medication-overuse headache: 0.2%). Headache was more prevalent in females (76.2%) than males (71.0%), a finding reflected only in migraine among the headache types. Headache was more prevalent among adolescents (77.6%) than children (68.4%), reflected in all types except migraine, although prevalence of UdH fell sharply after age 14 years to 3.9%.For headache overall, findings matched those in Turkey and Austria, obtained with the same questionnaire, but the high prevalence of migraine, not increasing with age, was surprising. The study highlighted diagnostic difficulties in young people, especially when poorly educated, with migraine diagnoses driven by improbably high proportions reporting nausea (44.8%) and vomiting (28.0%) as usual symptoms accompanying their headaches.ConclusionsHeadache is very common in children and adolescents in Ethiopia. This has major public-health implications, since half the country’s population are aged under 18 years.

The prevalence of headache disorders in children and adolescents in Lithuania: a schools-based study

BackgroundWhile the Global Burden of Disease (GBD) study reports headache disorders as the second-highest cause of disability worldwide, the headache data in GBD come very largely from adults. This national study in Lithuania was part of a global schools-based programme within the Global Campaign against Headache contributing data from children (7–11 years) and adolescents (12–17 years).MethodsThe methods followed the generic protocol for the global study. The basic study design was a cross-sectional survey. Self-completed structured questionnaires were administered, within classes, in 24 schools selected from seven regions of Lithuania to be nationally representative. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH).ResultsOf 3714 potential participants, 2505 (children 1382 [55.2%], adolescents 1123 [44.8%]; males 1169 [46.7%], females 1336 [53.3%]) completed the questionnaire. Adolescents and males were therefore relatively under-represented, with non-participation (32.6%) due in most cases to lack of parental consent. Observed lifetime prevalence of headache was 92.2%. Gender- and age-adjusted 1-year prevalence was 76.6% (migraine: 21.4%; tension-type headache [TTH]: 25.6%; UdH: 24.0%; all headache on ≥15 days/month: 3.9%; probable medication-overuse headache: 0.8%). All headache types except UdH were more prevalent among females than males, and among adolescents than children. UdH showed a complex relationship with age, but represented 38.0% of all reported headache in children, 27.4% in adolescents. Headache yesterday (HY) was reported by 17.5%, almost double the 9.8% predicted from prevalence and headache frequency to have headache on any day. The reason was unclear.ConclusionsFindings were not very different from those reported in Turkey and Austria, but with more TTH. Headache has, therefore, again been shown to be common in children and adolescents, and UdH confirmed as a headache type that must be recognised and included in accounts of headache in these age groups.

Prevalence of Headache Disorders, their Impact on the Daily Lifestyle of the Patients, and the Correlation of their Demographic and Clinical Features with Headache Impact Test 6

Introduction: Headache disorders are common among people of all ethnic groups. Primary headache disorders include migraine, tension-type headache, cluster headache, and chronic daily headache syndrome. Secondary headaches include medication overuse headache. The aim of this study is to evaluate the prevalence of various types of headaches disorders, their impact on the daily lifestyle of the patients, and the correlation of their demographic and clinical features with Headache Impact Test 6 (HIT-6). Materials and methods: This prospective study was conducted at a tertiary care hospital in Karachi for a period of six months. 198 patients who came in the outpatient (OPD) department and had a diagnosis of headache were included in this study irrespective of their age and gender. The demographic features, clinical features, and the final diagnoses made by the attending physician using the International Classification of Headache Disorders II (ICHD-II) were recorded. The impact of headaches on the daily lifestyle of the patients was determined by using a six-item HIT-6 questionnaire. For continuous variables, the means and standard deviations were calculated. Whereas for categorical data, frequencies and percentages were calculated. Effect modifiers like demographic and clinical features were controlled through stratification, Fischer’s exact test was used and a p-value of ≤0.05 was taken as significant. Results: The mean age of the patients was 34.39±15.58 years. Age distribution showed 90 (45.45%) patients of eight to 30 years, 84 (42.42%) patients of 31-50 years, and 24 (12.12%) patients of 51-75 years of age. There were 69 (34.8%) male and 129 (65.2%) female patients. The unmarried patients were 81 (40.9%) and married patients were 117 (59.1%). The lower-class patients were 94 (47%), the working-class patients were 87 (43.9%), the middle-class patients were 15 (7.6%), and the upper-class patients were three (1.5%). Primary headache was diagnosed in 150 (75.8%), and the secondary headache was diagnosed in 48 (24.2%) patients. 45 (22.7%) patients had throbbing, 87 (43.9%) had stabbing, and 66 (33.3%) had pressing headache quality. Unilateral headache was in 108 (54.5%), and the bilateral headache was in 90 (45.5%) patients. Pulsatile headache was in 102 (51.5%), and the non-pulsatile headache was in 96 (48.5%) patients. 51 (25.8%) patients had approximately one hour, 42 (21.2%) patients had more than four hours, and 105 (53%) patients had a continuous headache. The frequency was two to three times per week in 51 (25.8%), daily in 81 (40.9%), and variable in 66 (33.3%) patients. The headache occurred in the morning in 39 (19.7%), in the afternoon in 12 (6.1%), in the evening in 24 (12.1%), in the night in 30 (15.2%), and variably in 93 (47%) patients. Headache was mild in 36 (18.2%), moderate in 93 (47%), and severe in 69 (34.8%) patients. Aura, nausea, vomiting, photophobia, phonophobia, runny nose, and lacrimation were also present in many patients. 78 (39.4%) patients had a tension-type headache, and 60 (30,3%) had a migraine while others had several different conditions. The average HIT-6 score was 65.86±7.506. The severe impact was found in 168 (84.8%) patients, substantial impact in nine (4.5%), some impact in 12 (6.1%), and no impact in nine (4.5%) patients. Stratification showed a significant relationship with age, marital status, socioeconomic status, quality of headache, site of headache, pulsatile/non-pulsatile feature, frequency of headache, the severity of headache, and nausea. Conclusions: Tension-type and migraine headaches are the most common headaches that mostly affect young to middle-aged married females of low socioeconomic status. Age, marital status, socioeconomic status, quality of headache, site of headache, pulsatile/non-pulsatile feature, frequency of headache, the severity of headache, and nausea are some of the determinants of the impact of headaches on daily life. Further studies are needed to validate these conclusions.

Annual indirect costs secondary to headache disability in Brazil.

Disability imposed by headache disorders constitutes an expressive economic burden, mostly from indirect costs due to absenteeism and presenteeism. To estimate indirect costs from absenteeism and presenteeism due to headache disorders in Brazil. In a secondary, descriptive analysis of two nationwide databases, we estimated indirect costs based on headache-related disability and socioeconomic data. In the first database analyzed (n = 3838), 12.8% of the employed population with headache disorders missed at least 1 day of work in the last 3 months (mean, 95% CI = 4.2 days [3.7-4.6]). Based on the prevalence of headache disorders, days lost due to headaches and income data, R$ 40.4 billion (Int$ 20 billion) are lost due to headache-related absenteeism annually. For presenteeism, 26.2% of the employed population with headache disorders worked at least 1 day in the last 3 months with 50% reduced productivity (mean, 95% CI = 5.7 days [5.3-6.2]), amounting to R$ 27.3 billion (Int$ 13.5 billion) of financial loss annually. In the other database analysed (n = 205,546), 14,052 (6.8%) respondents missed work/school or household duties in the past 2 weeks due to some disease. Of these, 4.7% attributed their days lost to headaches disorders in the economically active population, which ranked 4th as main cause of days lost due to disease, among 23 common diseases. The economic burden of headache disorders in Brazil, mostly due to migraine (55.4%), may cost up to R$ 67.6 billion (Int$ 33.5 billion) annually, and headache disorders represent a leading cause of absenteeism due to disease.

EHMTI-0226. Prevalence of headache disorders in three different social settings

In the whole material, 1-year prevalence of headache was 67%, migraine 15% and tension type headache (TTH) 58%. In females the prevalence of migraine in students (35%) was significantly higher than in workers(16%) and blood donors(19%), p < 0.0001.In males the prevalence of migraine in students(15%) was also significantly higher than in workers(4%) and donors(5%), p < 0.0001. The prevalence of TTH in females was respectively 77%, 65% and 66%. In males the prevalence of TTH in students (79%) was significantly higher than in workers( 32% )and blood donors(59%), p < 0.0001, the prevalence of TTH in donors (59%) was significantly higher than in workers (32%), p < 0.0001. Only few (18%) had consulted because of headache. Particularly the very high prevalence of migraine and TTH in students is important and calls for further studies of risk factors and possibilities for preventive measures. Conclusions We show for the first time convincingly that headache disorders have different prevalence according to social setting. They represent a huge health problem in Russia. No conflict of interest.

Epidemiology of Headache Disorders in the Asia‐Pacific Region

Headache disorder is a major public health issue and is a great burden for the person, the health care system, and society. This article reviews epidemiological surveys of primary headache disorders including migraine and tension-type headache (TTH) among adults in the Asia-Pacific region using the International Classification of Headache Disorders (ICHD), first or second edition. Chronic daily headache (CDH), which is not an official diagnosis in the ICHD, was also reviewed. In the Asia-Pacific region, the median (range) 1-year prevalence of primary headache disorders was 9.1% (1.5-22.8%) for migraine, 16.2% (10.8-33.8%) for TTH, and 2.9% (1.0-3.9%) for CDH. The 1-year prevalence of migraine and TTH were rather consistent; however, the extremes in the 1-year prevalence of migraine in earlier studies from Hong Kong (1.5%) and South Korea (22.3%) were not repeated in later surveys (Hong Kong: 12.5%; South Korea: 6%). According to the United Nations, the estimated population of the Asia-Pacific region was 3.85 billion in 2010, equaling to headache suffers of 350 million patients with migraine, 624 million with TTH, and 112 million with CDH; many remain to be treated. The prevalence of headache disorders has remained stable over the last 2 decades in this region, where the diversity of geography, race, and development is wide. Thus, the pursuit of better headache care in this region might be our next challenge.

Prevalence and sociodemographic correlates of primary headache disorders: results of a population-based survey from Bangalore, India.

Headache disorders are common and burdensome throughout the world, placing high demand on health care services. Good information on their prevalence and distribution through sectors of the population are a prerequisite for planning interventions and organizing services, but unavailable for India. To find out the prevalence of headache disorders in Karnataka State and establish important sociodemographic associations. Using a door to door survey technique, amongst 2997 households, 2329 individuals were interviewed with a validated structured questionnaire by randomly sampling one adult member (aged 18-65 years) from eligible households in urban (n = 1226) and rural (n = 1103) areas of Bangalore, during the period April 2009 and January 2010. Chi-square, odds ratio (OR), and logistic regression. The 1-year prevalence of headache was 63.9% (62.0% when adjusted for age, gender and habitation) and 1-day prevalence (headache on the day prior to the survey) was 5.9%. Prevalence was higher in the age groups of 18-45 years, among females (OR = 2.3; 95% confidence interval: 1.9-2.7) and those in rural areas. Prevalence was higher in rural (71.2 [68.4-73.8]) than in urban areas (57.3 [54.5-60.1]) even after adjusting for gender. The proportion of days lost to headache from paid work was 1.1%, while overall productivity loss (from both paid and household work) was 2.8%. Headache disorders are a major health problem in India with significant burden. It requires systematic efforts to organize effective services to be able to reach a large number of people in urban and rural India. Education of physicians and other health-care workers, and the public should be a pillar of such efforts.

The Yekaterinburg headache initiative: an interventional project, within the Global Campaign against Headache, to reduce the burden of headache in Russia.

BackgroundAs major causes of global public ill-health and disability, headache disorders are paradoxically ignored in health policy and in planning, resourcing and implementing health services. This is true worldwide. Russia, where the prevalence of headache disorders and levels of attributed disability are well in excess of the global and European averages, is no exception, while arcane diagnoses and treatment preferences are an aggravating factor. Urgent remedial action, with political support, is called for.MethodsYekaterinburg, in Sverdlovsk Oblast, is the chosen centre for a demonstrational interventional project in Russia, undertaken within the Global Campaign against Headache. The initiative proposes three actions: 1) raise awareness of need for improvement; 2) design and implement a three-tier model (from primary care to a single highly specialized centre with academic affiliation) for efficient and equitable delivery of headache-related health care; 3) develop a range of educational initiatives aimed at primary-care physicians, non-specialist neurologists, pharmacists and the general public to support the second action.Results and conclusionWe set these proposals in a context of a health-care needs assessment, and as a model for all Russia. We present and discuss early progress of the initiative, justify the investment of resources required for implementation and call for the political support that full implementation requires. The more that the Yekaterinburg headache initiative can achieve, the more likely it is that this support will be forthcoming.

Headache Disorders in the Millennium Cohort: Epidemiology and Relations With Combat Deployment

(Headache 2011;51:1098‐1111)Objective.— Characterize migraine and other headache disorders within a large population‐based US military cohort, with an emphasis on the temporal association between military deployment and exposure to combat.Background.— Little research has been published on the prevalence of headache disorders in the US military population, especially in relation to overseas deployments and exposure to combat. A higher than expected prevalence of migraine has previously been reported among deployed US soldiers in Iraq, suggesting an association. Headache disorders, including migraine, could have important effects on the performance of service members.Methods.— A total of 77,047 US active‐duty, Reserve, and National Guard members completed a baseline questionnaire between July 2001 to June 2003 for the Millennium Cohort Study. Headache disorders were assessed using the following survey‐based measures: self‐reported history of provider‐diagnosed migraine, recurrent severe headache within the past year, and recent headaches/bothered a lot within the past 4 weeks. Follow‐up surveys were completed on average 3 years after baseline (mean = 2.7 years; range = 11.4 months to 4.5 years).Results.— The overall male and female prevalence of self‐reported headache conditions at baseline were: provider‐diagnosed migraine, 6.9% and 20.9%, respectively; recurrent severe headache, 9.4% and 22.3%, respectively; and bothered a lot by headaches, 3.4% and 10.4%, respectively. Combat deployers had significantly higher odds of any new‐onset headache disorders than non‐deployers (adjusted odds ratios = 1.72 for men, 1.84 for women; 95% confidence intervals, 1.55‐1.90 for men, 1.55‐2.18 for women), while deployers without combat exposure did not.Conclusions.— Deployed personnel with reported combat exposure appear to represent a higher risk group for new‐onset headache disorders. The identification of populations at higher risk of development of headache provides support for targeted interventions.

Time trends in the prevalence of headache disorders. The Nord-Trøndelag Health Studies (HUNT 2 and HUNT 3)

Earlier reports regarding secular trends of migraine are conflicting, and there is a lack of long-term follow-up studies of other headache syndromes among adults. The aim of the present study was to assess any changes in the prevalence of the major headache types in a large adult population. With an 11-year interval, all inhabitants aged ≥20 years (n = 92,566 and 94,194) in the Norwegian county of Nord-Trøndelag were invited to participate in two cross-sectional surveys. Attendance rates were 56% and 42%. The age-adjusted 1-year prevalences, according to the diagnostic criteria of the International Headache Society, sex-ratios and attack frequencies were assessed. The migraine prevalence increased from 12.1% to 13.2% (P < 0.001), but the sex ratio did not change. The prevalence of non-migrainous headache overall decreased (26.0% vs 24.2%; P < 0.001). The prevalences of 'headache suffering' (37.4%), chronic daily headache (2.5%) and medication overuse headache (1.0%) remained stable. Apart from a small increase of migraine, headache prevalences remained essentially stable among adults in a Norwegian county during an 11-year period.

Overview of Pediatric Headache.

There is a high prevalence of headache disorders in children and adolescents. Headache in pediatric population is substantially underdiagnosed and undertreated. The recently revised International Headache Society criteria are a step in the right direction to improve our diagnostic accuracy. The recent increases in evidence-based data in the pediatric headache population will help to outline appropriate management strategies for acute and preventive treatment. In this article, diagnostic and treatment issues related to the pediatric headache patient will be reviewed.

An epidemiologic study of headache among children and adolescents of southern Brazil.

To study the epidemiology of pediatric headache, we conducted a cross-sectional study of a randomized and proportional sample of 538 male and female students, 10 to 18 years old. They were in the 5th to 8th grade of the schools of Porto Alegre, RS, Brazil. The headache disorders were classified on the basis of clinical interview as well as a physical and neurological examination using the operational diagnostic criteria of the International Headache Society (IHS). The following headache prevalences were found: lifetime, 93.2%; last year, 82.9%; last week, 31.4%; last 24 h, 8.9%. Last week and last 24 h headache complaints were twice as prevalent in the female group. During the last year the prevalence of headache disorders was 72.8% for tension-type and 9.9% for migraine headache and was not associated with age distribution. Only the last year and last week prevalences of tension-type headache were significantly higher in the female group. The last year prevalence of headache disorders proved to be positively associated with sex and age variables. The prevalence of headache disorders was found to be extremely high in this population group, requiring more attention on the part of investigators as a public health problem.