Chronic daily headache in adolescents. Prevalence, impact, and medication overuse. Neurology

Tzu Chi University, Hua-lien, Taiwan, Taiwan
Neurology (Impact Factor: 8.29). 01/2006; 66(2):193-7. DOI: 10.1212/01.wnl.0000183555.54305.fd
Source: PubMed


To examine the prevalence, impact, and related medication use or overuse of primary chronic daily headache (CDH) among adolescents in a field sample.
The authors conducted a two-phase CDH survey of all students from ages 12 to 14 years in five selected middle schools in Taiwan. Subjects with CDH in the past year were identified and interviewed by neurologists. CDH was defined as headache occurring at a frequency of 15 days/month or more, average of 2 hours/day or more, for more than 3 months, and its subtypes were classified on the basis of the International Classification of Headache Disorders, 2nd edition.
Of the 7,900 participants, 122 (1.5%) fulfilled the criteria for primary CDH in the past year. Girls had a higher prevalence (2.4%) than boys (0.8%) (p < 0.001). Of the CDH subjects, 88 (72%) could be classified into either chronic tension-type headache (65.6%) or chronic migraine (6.6%). None of them fulfilled the criteria of new daily-persistent headache or hemicrania continua. Twenty-four subjects (20%) overused medications. Eighty-two (67%) of all CDH subjects had migraine or probable migraine. In the past semester, most CDH subjects (65%) did not take any sick leave for headaches. Only 6 subjects consulted neurologists in the past year, and only 1 subject took headache prophylactic agents.
Chronic daily headache (CDH) was common in a large nonreferred adolescent sample. Based on the International Classification of Headache Disorders, 2nd edition, criteria, chronic tension-type headache was the most common subtype; however, a majority of adolescents with CDH had headaches with features of migraine.

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Available from: Jong-Ling Fuh, May 30, 2014
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    • "The prevalence seems to decrease with increasing age, and among people over 65 years, the prevalence based on different definitions has been reported to be 1.0%–1.5%.47,48 The prevalence of MOH in children and adolescents has been suggested to be 0.3%–0.5%.49,50 In studies of specialist care in children, approximately 20% of patients with chronic headache had medication-overuse, suggesting MOH to be a problem also in school-aged children.51,52 "
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    ABSTRACT: Medication-overuse headache (MOH) is a worldwide health problem with a prevalence of 1%-2%. It is a severe form of headache where the patients often have a long history of headache and of unsuccessful treatments. MOH is characterized by chronic headache and overuse of different headache medications. Through the years, withdrawal of the overused medication has been recognized as the treatment of choice. However, currently, there is no clear consensus regarding the optimal strategy for management of MOH. Treatment approaches are based on expert opinion rather than scientific evidence. This review focuses on aspects of epidemiology, diagnosis, pathogenesis, prevention, and treatment of MOH. We suggest that information and education about the risk of MOH is important since the condition is preventable. Most patients experience reduction of headache days and intensity after successful treatment. The first step in the treatment of MOH should be carried out in primary care and focus primarily on withdrawal, leaving prophylactic medication to those who do not manage primary detoxification. For most patients, a general practitioner can perform the follow-up after detoxification. More complicated cases should be referred to neurologists and headache clinics. Patients suffering with MOH have much to gain by an earlier treatment-focused approach, since the condition is both preventable and treatable.
    Journal of Pain Research 06/2014; 7:367-78. DOI:10.2147/JPR.S46071
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    • "The prevalence decreases with older age and, among people over 65 years in Taiwan, the prevalence was 1.0% [Wang et al. 2000]. The prevalence of MOH in children and adolescents has been suggested to be 0.3–0.5% [Dyb et al. 2006; Wang et al. 2006]. MOH generally starts earlier in life than other types of chronic headache [Colás et al. 2004]. "
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    ABSTRACT: Medication-overuse headache (MOH) is one of the most common chronic headache disorders and a public health problem with a worldwide prevalence of 1-2%. It is a condition characterized by chronic headache and overuse of different headache medications, and withdrawal of the overused medication is recognised as the treatment of choice. However, the strategy for achieving withdrawal is, at present, based on expert opinion rather than scientific evidence, partly due to the lack of randomised controlled studies. This narrative review investigates different aspects of epidemiology, diagnosis, risk factors and pathogenesis as well as management for MOH. We suggest that the first step in the treatment of MOH should be carried out in general practice and should focus primarily on detoxification. For most patients, both prevention and follow up after detoxification can also be performed in general practice, thus freeing resources for referral of more complicated cases to headache clinics and neurologists. These suffering patients have much to gain by an earlier treatment-focused approach lower down on the treatment ladder.
    Therapeutic Advances in Drug Safety 03/2014; 2(5):87-99. DOI:10.1177/2042098614522683
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    • "In our study, we found the similar prevalence rate of migraine i.e. 13.7% but decreased prevalence rate of TTH i.e. 12.6% in comparison to previous population base studies conducted in Turkey (Key et al 2004, Boru et al 2005, Koseoglu et al 2003). CDH was not common in our sample similar to previous reports (Wang et al 2006). Chronic tensiontype headache was the most common subtype; however, only 3 of patients with CDH had headaches with features of migraine. "
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    ABSTRACT: Purpose: The aim of this study was to evaluate the prevalence of headache in psychiatry clinics. Method: Three hundred and seventy two consecutive patients aged between 18 and 82 (Mean: 36.4±13.2) years were interviewed with a semi-structured interview form. All patients were asked whether they had headache or not. If they answered 'yes, the differential diagnosis of headache was made. Findings: Two-hundred and fifty-two patients (67.7%) did not complain any kind of headache. Migraine (13.7%, n=51) and tension type headaches (12.6%, n=47) were the most commonly seen headaches in psychiatry outpatient clinics. The frequency of migraine in subjects with anxiety di-sorder was higher than that in subjects with other psychiatric conditions including major depressi-on. The frequency of tension type headache was higher in subjects with anxiety disorder in com-parison to other psychiatric disorders, too. We found a statistically significant positive relationship between anxiety disorder or depression, and headache disorders (p<0.00). The tension type or chronic daily headache was seen at later ages but migraine in younger ages (p<0.00). The preva-lence of migraine was similar in psychiatry clinics and in the general population of Turkey previ-ously reported. The similar frequency of headache in psychiatry clinics is probably due to a comor-bidity with psychiatric diseases. Discussion and Conclusion: We concluded that it was important to ask standard questions abo-ut headache in the course of the anamnesis in patients with major depression and anxiety disor-der. ÖZET Psikiyatrik Bozuklu¤u Olan Türk Hastalarda Bafla¤r›s› S›kl›¤› Amaç: Bu çal›flman›n amac› psikiyatri klini¤inde bafla¤r›s› prevalans›n›n de¤erlendirilmesidir. Yöntem: Yafllar› 18 ile 82 y›l aras›nda de¤iflen (Ortalama: 36.4±13.2 y›l) ard› s›ra 372 hasta yar› ya-p›land›r›lm›fl form ile sorguland›. Tüm hastalara bafla¤r›lar› olup olmad›¤› soruldu. 'Evet' cevab› ve-renlerin bafla¤r›s› ay›r›c› tan›lar› yap›ld›. Bulgular: Hastalar›n 252'si (%67.7) hiç bir bafla¤r›s› çeflidi târif etmediler. Migren (%13.7, n=51) ve gerilim türü bafla¤r›s› (%12.6, n=47) psikiyatri polikliniklerinde en s›k rastlanan bafla¤r›lar› olarak bulundu. Majör depresyon dâhil olmak üzere di¤er psikiyatrik durumlara k›yasla anksiyete bozuk-lu¤u olgular›nda migren daha s›kt›. Di¤er psikiyatrik durumlara k›yasla anksiyete bozuklu¤u olgu-lar›nda gerilim türü bafla¤r›s› da daha s›kt›. Anksiyete bozuklu¤u ya da depresyon varl›¤› ile bafla¤-r›lar› aras›nda istatsitiksel olarak anlaml› ve pozitif yönde bir iliflki bulduk (p<0.00). Gerilim türü ba-fla¤r›s› daha ileri yafllarda gözlenirken migren daha genç yafllarda görülür (p<0.00). Psikiyatri Polik-lini¤i'ndeki migren prevalans› daha önce Türkiye'den bildirilmifl raporlara benzer biçimde bulun-du. Tart›flma ve Sonuç: Benzer s›kl›kta bafla¤r›s› varl›¤› psikiyatrik hastal›klarla bafla¤r›s› aras›ndaki
    Yeni Symposium 01/2010;
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