MIGRAINE HEADACHE - EPIDEMIOLOGY AND HEALTH-CARE UTILIZATION

Population-based studies of headache can help inform the development o f diagnostic criteria. In population-based studies, migraine has been consistently revealed as a common disabling condition that affects mal es and females of all ages. From data obtained in a national survey of the United States population, we show that the prevalence of migraine and the frequency of attacks increase as household income decreases. Disability from attacks is not related to income. In contrast, physici an diagnosis is more likely as household income increases. Moreover, p hysician diagnosis is more likely among females, older cases, those mo re likely to experience disability, and migraine sufferers reporting n ausea (males), vomiting, and visual and sensory aura. Analysis of our data leads us to conclude that the symptoms most strongly associated w ith diagnosis may provide the greatest concern and interest on the par t of physicians to make a diagnosis, even though other migraine-relate d symptoms are more common in the population and in clinical settings. Finally, among migraine sufferers with severe disability, a very larg e proportion do not receive the benefits of medical diagnosis and trea tment. Though most migraine sufferers use OTC medications, given the f requency and associated disability of their migraine attacks, current therapy appears unsatisfactory.