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Recurrent Headache and Migraine as a Public Health Problem—A Population-Based Study in Sweden

Authors

  • Anu Molarius PhD,

  • Åke Tegelberg DDS, PhD


  • From the Västmanland County Council, Department of Community Medicine, Västerås, Sweden (Dr. Molarius) and Centre for Clinical Research, Uppsala University, Västerås, Sweden (Dr. Tegelberg).

Address all correspondence to Dr. Anu Molarius, Västmanland County Council, Department of Community Medicine, 721 51 Västerås, Sweden.

Abstract

Objective.—To study the prevalence of recurrent headache and/or self-considered migraine (RH/M) and its association with self-rated health, other symptoms, and use of health care and medication in the general population.

Methods.—The study comprised a random population sample of 43,770 men and women aged 18 to 79 years covering an area of 58 municipalities in Sweden. The data were obtained using a postal survey questionnaire during March to May 2000. The overall response rate was 65%.

Results.—The overall prevalence of self-reported RH/M was 10% among men and 23% among women. RH was more common (15%) than migraine (4%). The prevalence of RH was highest in the younger age groups (18 to 34 years) and decreased with increasing age. The prevalence of migraine was highest (6%) among 35 to 49 years old. Subjects with RH/M had poorer self-rated health compared to subjects with no reported headache independent of age. Poor self-rated health was most common among subjects with both RH and M. Musculoskeletal pain and psychosomatic symptoms were more common among those with RH/M. The association between RH/M and poor self-rated health was partly explained by these symptoms. Those with RH/M utilized more health care at all levels than those with no RH/M. In addition, subjects with RH/M reported two to three times more often that they had been in need of medical care but not sought it. About two-thirds of the subjects with RH/M had used analgesic during the last 2 weeks compared with less than one-third among subjects with no RH/M.

Conclusion.—RH/M constitutes a substantial public health problem that mainly affects young and middle aged adults. It is associated with poor self-rated health, musculoskeletal and psychosomatic symptoms, increased use of health care and medication as well as unmet needs of health care.

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