Albert Einstein College of Medicine and Montefiore Headache Center, Bronx, NY 10461, USA.
Headache. 2011 May;51(5):693-706. doi: 10.1111/j.1526-4610.2011.01885.x.
To estimate the prevalence of chronic migraine (CM) among adolescents and to describe the epidemiologic profile, headache characteristics, disability, and healthcare utilization of adolescents with CM in the USA.
Chronic daily headache (CDH) and CM occur in children and adolescents, but are poorly understood in these populations because their presentation is different from that in adults. It may be difficult to assign a definitive diagnosis to young people suffering from CDH because symptoms may fail to meet the criteria for one of the CDH subtypes.
A large sample of households with at least one resident aged 12 to 19 years was selected in balance with the US Census. Data were collected in 3 phases: (1) mailed questionnaire; (2) telephone interview; and (3) 30-day interactive voice response system diary. CM prevalence was estimated by adapting the second edition of the International Classification of Headache Disorders criteria for CM to include pediatric migraine diagnostic criteria. The population was stratified for medication overuse. Medication overuse was defined as 15 or more days per month of acute medication use. Included in the study were measures of headache characteristics, headache impact (Headache Impact Test), disability (Pediatric Migraine Disability Assessment), and healthcare and medication use. Data are reported on subjects 12 to 17 years of age only.
The US adolescent (12-17 years) prevalence rate for CM was 0.79% (0.00-1.70) excluding those with medication overuse and 1.75% (0.62-2.89) when adolescents with medication overuse were included. The majority of adolescents with CM had Headache Impact Test scores greater than or equal to 60, indicating severe headache impact, and mean Pediatric Migraine Disability Assessment scores greater than 17, indicating severe headache and disability. The majority of adolescents with CM (approximately 60%) had not visited a healthcare provider in the previous year and less than one in 5 reported taking medications to prevent headaches during the last month.
Results suggest that CM occurs less frequently in adolescents than adults, but like adults, adolescents are severely burdened by the disorder. Data support an unmet medical need; however, the development of optimal criteria for diagnosing adolescents with CM is critical to fully understanding how medical needs can be met within this complex population.
估计美国青少年慢性偏头痛（CM）的患病率，并描述美国青少年 CM 的流行病学特征、头痛特征、残疾和医疗保健利用情况。
慢性每日头痛（CDH）和 CM 发生在儿童和青少年中，但由于其表现与成年人不同，因此在这些人群中了解甚少。由于患有 CDH 的年轻人的症状可能不符合 CDH 亚型之一的标准，因此可能难以对其进行明确诊断。
选择了一个与美国人口普查相平衡的有至少一名年龄在 12 至 19 岁居民的家庭的大样本。数据收集分三个阶段进行：（1）邮寄问卷；（2）电话访谈；（3）30 天互动语音应答系统日记。CM 的患病率是通过改编国际头痛疾病分类第 2 版的 CM 标准来估计的，该标准包括儿科偏头痛诊断标准。人群按药物滥用进行分层。药物滥用定义为每月使用急性药物 15 天或以上。研究包括头痛特征、头痛影响（头痛影响测试）、残疾（儿科偏头痛残疾评估）和医疗保健及药物使用的测量。仅报告 12 至 17 岁年龄组的受试者数据。
美国青少年（12-17 岁）CM 的患病率为 0.79%（0.00-1.70），不包括药物滥用者，包括药物滥用者时为 1.75%（0.62-2.89）。大多数患有 CM 的青少年的头痛影响测试分数大于或等于 60，表明严重的头痛影响，平均儿科偏头痛残疾评估分数大于 17，表明严重的头痛和残疾。大多数患有 CM 的青少年（约 60%）在过去一年中未就诊，不到五分之一的人报告在过去一个月内服用药物预防头痛。
结果表明，CM 在青少年中的发生率低于成年人，但与成年人一样，青少年深受该疾病的困扰。数据支持医疗需求未得到满足；然而，制定最佳标准来诊断青少年 CM 对于充分了解如何满足这一复杂人群的医疗需求至关重要。
