Rasmussen B K
Glostrup Population Studies, Department of Internal Medicine C, Glostrup Hospital, University of Copenhagen, Denmark.
Cephalalgia. 1995 Feb;15(1):45-68. doi: 10.1046/j.1468-2982.1995.1501045.x.
This thesis is based on nine previously published papers. It represents the first prevalence study of specific headache entities in a representative general population, where the diagnoses are based on a structural interview and examination by a physician using internationally accepted operational diagnostic criteria. The study population was a random sample of 1000 men and women aged 25-64. The participation rate was 76%. The prevalences of the different forms of headache are assessed and the study provides descriptive data concerning symptomatology, precipitating factors, impact of female hormones, use of medical services and work consequences of the headache disorders and describes various factors associated with the disorders. Only half of migraineurs and one-sixth of subjects with tension-type headache consulted their general practitioner because of headache and even less consulted a specialist. These consultation rates reflect the selection of cases that may bias studies in clinic populations. The study supports the notion that migraine and tension-type headache are separate clinical entities and that migraine without aura and migraine with aura are distinct subforms of migraine. Migraine and tension-type headache are sex- and age-dependent disorders with female preponderance and lower prevalence in older age groups. The female preponderance may be explained by clinical factors related to female hormones. There is no clear evidence of any association between sociodemographic variables and migraine or tension-type headache. Tension-type headache is related to a series of psychosocial variables while migraine is not. The results suggest that migraine is primarily a constitutional disorder and tension-type headache a more complex phenomenon influenced by several psychosocial factors. The limitations of cross-sectional data in pointing out risk factors with sufficient certainty are stressed. Longitudinal follow-up studies are the most important challenge in future epidemiological headache research.
本论文基于九篇先前发表的论文。它代表了在具有代表性的普通人群中对特定头痛类型进行的首次患病率研究，其中诊断基于医生使用国际认可的操作性诊断标准进行的结构化访谈和检查。研究人群是从25 - 64岁的男性和女性中随机抽取的1000人。参与率为76%。评估了不同形式头痛的患病率，该研究提供了有关症状学、诱发因素、女性激素的影响、医疗服务使用情况以及头痛障碍对工作的影响等描述性数据，并描述了与这些障碍相关的各种因素。只有一半的偏头痛患者和六分之一的紧张型头痛患者因头痛咨询过他们的全科医生，咨询专科医生的更少。这些咨询率反映了病例的选择情况，这可能会使针对临床人群的研究产生偏差。该研究支持偏头痛和紧张型头痛是不同临床实体的观点，并且无先兆偏头痛和有先兆偏头痛是偏头痛的不同亚型。偏头痛和紧张型头痛是与性别和年龄相关的疾病，女性居多，且在老年人群中患病率较低。女性居多可能由与女性激素相关的临床因素来解释。没有明确证据表明社会人口统计学变量与偏头痛或紧张型头痛之间存在任何关联。紧张型头痛与一系列心理社会变量有关，而偏头痛则不然。结果表明，偏头痛主要是一种体质性疾病，而紧张型头痛是一种受多种心理社会因素影响的更为复杂的现象。强调了横断面数据在充分确定风险因素方面的局限性。纵向随访研究是未来流行病学头痛研究中最重要的挑战。
