Lucas Christian, Géraud Gilles, Valade Dominique, Chautard Marie-Hélène, Lantéri-Minet Michel
Neurological Clinic, Hospital Salengro, Lille, France.
Headache. 2006 May;46(5):715-25. doi: 10.1111/j.1526-4610.2006.00430.x.
To evaluate the proportion of migraineurs who are self-aware of their disease in France, to determine the factors (disability, quality of life, psychiatric comorbidities, and medical consultation) that may promote self-awareness of migraine, and to assess the influence of these factors on migraine attacks.
New recommendations for migraine diagnosis and medical management were released in 2003 by the French medicoeconomic evaluation service (ANAES). In addition, the revised classification of headache disorders recently issued by the International Headache Society includes probable migraine as a form of migraine. However, strict and probable migraine now appear to be part of the same spectrum of disease.
Subjects with migraine (strict or probable) according to the revised classification were identified by a postal questionnaire from a large representative sample of the French adult population. Migraine-related disability was assessed using the MIDAS questionnaire, anxiety and depression by the Hospital Anxiety and Depression scale (HADS), and health-related quality of life (HRQoL) by the 8 concepts of the Short-Form 12 (SF-12) questionnaire. Migraine management was assessed according to the use of recommended or nonrecommended treatments, and treatment efficacy according to the set of 4 questions designed by the ANAES.
Of the 10,532 subjects interviewed, 1,179 subjects (21.3%) were identified as migraineurs. Sixty percent of all migraine subjects were not self-aware that they had migraine. Medical consultation, duration of migraine history, severe intensity of attacks, impact on daily living, and female gender promoted self-awareness of migraine. On the other hand, HRQoL and anxiety and depression scores were not different between subjects self-aware or not self-aware of migraine. Only 20% of all migraine subjects were medically followed-up. Quality of the first medical consultation appears determinant for continued consulting. Subjects self-aware of migraine more frequently used recommended acute treatments of migraine, which proved more effective than nonrecommended treatments as assessed according to the ANAES set of questions.
Migraine medical diagnosis and follow-up remain low in France. Careful medical consultation is a prime factor for migraine subject self-awareness of migraine, continued consultation, and use of recommended medications for the treatment of migraine attacks.
评估法国偏头痛患者中自知患有该病的比例，确定可能促进偏头痛自知力的因素（残疾、生活质量、精神共病和就医情况），并评估这些因素对偏头痛发作的影响。
法国医疗经济评估服务机构（ANAES）于2003年发布了偏头痛诊断和药物治疗的新建议。此外，国际头痛协会最近发布的头痛疾病修订分类将可能的偏头痛列为偏头痛的一种形式。然而，严格偏头痛和可能的偏头痛现在似乎属于同一疾病谱。
根据修订分类，通过邮政问卷从法国成年人口的大型代表性样本中识别出患有偏头痛（严格或可能）的受试者。使用MIDAS问卷评估与偏头痛相关的残疾情况，使用医院焦虑抑郁量表（HADS）评估焦虑和抑郁情况，使用简短健康调查问卷（SF - 12）的8个概念评估健康相关生活质量（HRQoL）。根据推荐或非推荐治疗的使用情况评估偏头痛管理情况，并根据ANAES设计的4个问题集评估治疗效果。
在接受访谈的10532名受试者中，1179名受试者（21.3%）被确定为偏头痛患者。所有偏头痛受试者中有60%不知道自己患有偏头痛。就医、偏头痛病史时长、发作严重程度、对日常生活的影响以及女性性别促进了偏头痛的自知力。另一方面，自知或不自知患有偏头痛的受试者之间的HRQoL以及焦虑和抑郁评分没有差异。所有偏头痛受试者中只有20%接受了医学随访。首次就医质量似乎是持续就医的决定因素。自知患有偏头痛的受试者更频繁地使用推荐的偏头痛急性治疗方法，根据ANAES的问题集评估，这些方法比非推荐治疗更有效。
在法国，偏头痛的医学诊断和随访率仍然很低。仔细的就医是偏头痛患者自知患有偏头痛、持续就医以及使用推荐药物治疗偏头痛发作的主要因素。
