King's Centre for Military Health Research, Department of Psychological Medicine, King's College, London, UK.
Headache. 2013 May;53(5):787-98. doi: 10.1111/head.12101. Epub 2013 Apr 10.
To assess the importance of service demographic, mental disorders, and deployment factors on headache severity and prevalence, and to assess the impact of headache on functional impairment.
There is no information on prevalence and risk factors of headache in the UK military. Recent US reports suggest that deployment, especially a combat role, is associated with headache. Such an association may have serious consequences on personnel during deployment.
A survey was carried out between 2004 and 2006 (phase 1) and again between 2007 and 2009 (phase 2) of randomly selected UK military personnel to study the health consequences of the Iraq and Afghanistan wars. This study is based on those who participated in phase 2 and includes cross-sectional and longitudinal analyses. Headache severity in the last month and functional impairment at phase 2 were the main outcomes.
Forty-six percent complained of headache in phase 2, half of whom endorsed moderate or severe headache. Severe headache was strongly associated with probable post-traumatic stress disorder (multinomial odds ratio [MOR] 9.6, 95% confidence interval [CI] 6.4-14.2), psychological distress (MOR 6.15, 95% CI 4.8-7.9), multiple physical symptoms (MOR 18.2, 95% CI 13.4-24.6) and self-reported mild traumatic brain injury (MOR 3.5, 95% CI 1.4-8.6) after adjustment for service demographic factors. Mild headache was also associated with these variables but at a lower level. Moderate and severe headache were associated with functional impairment, but the association was partially explained by mental disorders. Mental ill health was also associated with reporting moderate and severe headache at both phase 1 and phase 2. Deployment and a combat role were not associated with headache.
Moderate and severe headache are common in the military and have an impact on functional impairment. They are more strongly associated with mental disorders than with mild traumatic brain injury.
评估服务人口统计学、精神障碍和部署因素对头痛严重程度和流行率的重要性，并评估头痛对功能障碍的影响。
英国军队中没有关于头痛的患病率和危险因素的信息。最近美国的报告表明，部署，特别是战斗角色，与头痛有关。这种关联可能会对部署期间的人员造成严重后果。
在 2004 年至 2006 年（第 1 阶段）和 2007 年至 2009 年（第 2 阶段）期间，对随机选择的英国军人进行了一项调查，以研究伊拉克和阿富汗战争对健康的影响。本研究基于参加第 2 阶段的人员，包括横断面和纵向分析。上一个月的头痛严重程度和第 2 阶段的功能障碍是主要结果。
第 2 阶段有 46%的人抱怨头痛，其中一半人表示头痛程度为中度或重度。严重头痛与可能的创伤后应激障碍（多项优势比[MOR]9.6，95%置信区间[CI]6.4-14.2）、心理困扰（MOR 6.15，95%CI 4.8-7.9）、多种身体症状（MOR 18.2，95%CI 13.4-24.6）和自我报告的轻度创伤性脑损伤（MOR 3.5，95%CI 1.4-8.6）高度相关，调整服务人口统计学因素后。轻度头痛也与这些变量相关，但程度较低。中度和重度头痛与功能障碍相关，但这种关联在一定程度上可以由精神障碍来解释。精神健康状况不佳也与第 1 阶段和第 2 阶段报告中度和重度头痛有关。部署和战斗角色与头痛无关。
中度和重度头痛在军队中很常见，对功能障碍有影响。它们与精神障碍的关系比与轻度创伤性脑损伤更为密切。
