VALIDATION OF DIAGNOSTIC-CRITERIA FOR MIGRAINE IN THE ZURICH LONGITUDINAL COHORT STUDY

This paper reports the results of a systematic assessment of the valid ity of the specific diagnostic criteria for migraine without aura, as defined by the International Headache Society (IHS), in a longitudinal epidemiologic sample of young adults who were selected from the gener al population of Zurich, Switzerland. Systematic modification of each of the IHS criteria for migraine without aura yielded one-year weighte d prevalence rates ranging from 24% for the unmodified IHS criteria to 9% for the most restrictive definition of migraine. The major implica tions of the findings for the IHS criteria are: (a) they provide adequ ate coverage to classify the majority of subjects with headache in the general population; (b) there is little overlap between migraine and tension-type headache, suggesting that the criteria define moderately independent subgroups; (c) the criteria for migraine without aura appe ar to be too unrestrictive for application in the community, particula rly among young adults at the peak period of incidence of migraine; (d ) the criteria for ''aura'' need more precise operationalization; and (e) models of validation of the diagnostic criteria suggest that Crite rion D of the IHS criteria for migraine without aura should be modifie d to require both gastrointestinal symptoms and photophobia and phonop hobia.