The impact of migraine on quality of life in the general population - The GEM study

Objective: To assess health-related quality of life (HRQOL) in migraineurs in the general population. Design: Cross-sectional study within the context of a population-based study monitoring health characteristics of the Dutch adult population in two municipalities representative of the general popul ation in the Netherlands. Migraine was assessed in a multistaged procedure that included a semistructured clinical interview by telephone. Final diagn osis met 1988 International Headache Society criteria. HRQOL was measured w ith the self-administered RAND 36-item Health Survey (RAND-36), including p hysical functioning, social functioning, role limitations, and physical per ception. HRQOL of migraineurs was compared with that of nonmigraineurs. To compare and study the effect of comorbidity, the authors also identified su bjects with asthma or chronic musculoskeletal pain. There were 5998 people with complete data, 620 of whom had migraine in the last year. Results: Com pared with nonmigraineurs, significantly more migraineurs had asthma (OR = 1.6; 95% CI 1.1, 2.4) or chronic musculoskeletal pain (OR = 1.7; 95% CI 1.5 , 2.1). Migraineurs reported diminished functioning and well-being on all e ight domains as compared with nonmigraineurs. HRQOL was inversely related t o attack frequency (p < 0.0002). Migraineurs had a poorer HRQOL than did th ose reporting asthma, except for dimensions concerning physical functioning and general health perception, but they had a better HRQOL than did subjec ts with chronic musculoskeletal pain. Comorbidity of asthma or chronic musc uloskeletal pain in migraine further reduced HRQOL. Conclusions: Migraineur s report more asthma and chronic musculoskeletal pain. Compared with nonmig raineurs and to others with chronic conditions, migraineurs report compromi sed physical, mental, and social functioning, particularly those with a hig h frequency of attack.