Prevalence and Burden of Chronic Migraine in Adolescents: Results of the Chronic Daily Headache in Adolescents Study (C-dAS)
Prevalence and Burden of Chronic Migraine in Adolescents: Results of the Chronic Daily Headache in Adolescents Study (C-dAS)
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DOI：
10.1111/j.1526-4610.2011.01885.x
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发表时间：
2011-05-01
期刊：
影响因子：
5
通讯作者：
Winner, Paul
中科院分区：
文献类型：
--
作者：
Lipton, Richard B.;Manack, Aubrey;Winner, Paul
客观。-评估青少年慢性偏头痛（CM）的患病率，并描述美国CM青少年的流行病学特征、头痛特征、残疾和医疗保健利用。慢性每日头痛（CDH）和CM发生在儿童和青少年中，但在这些人群中了解甚少，因为它们的表现与成人不同。它可能是难以分配一个明确的诊断患有CDH的年轻人，因为症状可能不符合标准的CDH亚型之一。根据美国人口普查的平衡，选择了至少有一名12至19岁居民的大样本家庭。资料收集分三个阶段：（1）邮寄问卷;（2）电话访谈;（3）30天交互式语音应答系统日志。通过调整第二版国际头痛疾病分类标准以包括儿童偏头痛诊断标准来估计CM患病率。对人群进行药物过度使用分层。药物过度使用定义为每月急性药物使用15天或以上。该研究包括头痛特征、头痛影响（头痛影响测试）、残疾（儿科偏头痛残疾评估）以及医疗保健和药物使用的测量。数据仅报告了12至17岁的受试者。美国青少年（12-17岁）CM的患病率为0.79%（0.00-1.70），不包括药物过度使用的青少年，当包括药物过度使用的青少年时，CM的患病率为1.75%（0.62-2.89）。大多数患有CM的青少年的头痛影响测试评分大于或等于60，表明严重的头痛影响，平均儿童偏头痛残疾评估评分大于17，表明严重的头痛和残疾。大多数患有CM的青少年（约60%）在过去一年中没有访问过医疗保健提供者，并且不到五分之一的人报告在过去一个月内服用药物预防头痛。结果表明，CM发生在青少年比成年人少，但像成年人一样，青少年严重负担的疾病。数据支持未满足的医疗需求;然而，制定诊断青少年CM的最佳标准对于充分了解如何在这一复杂人群中满足医疗需求至关重要。
Objective.-To estimate the prevalence of chronic migraine (CM) among adolescents and to describe the epidemiologic profile, headache characteristics, disability, and healthcare utilization of adolescents with CM in the USA.Background.-Chronic daily headache (CDH) and CM occur in children and adolescents, but are poorly understood in these populations because their presentation is different from that in adults. It may be difficult to assign a definitive diagnosis to young people suffering from CDH because symptoms may fail to meet the criteria for one of the CDH subtypes.Methods.-A large sample of households with at least one resident aged 12 to 19 years was selected in balance with the US Census. Data were collected in 3 phases: (1) mailed questionnaire; (2) telephone interview; and (3) 30-day interactive voice response system diary. CM prevalence was estimated by adapting the second edition of the International Classification of Headache Disorders criteria for CM to include pediatric migraine diagnostic criteria. The population was stratified for medication overuse. Medication overuse was defined as 15 or more days per month of acute medication use. Included in the study were measures of headache characteristics, headache impact (Headache Impact Test), disability (Pediatric Migraine Disability Assessment), and healthcare and medication use. Data are reported on subjects 12 to 17 years of age only.Results.-The US adolescent (12-17 years) prevalence rate for CM was 0.79% (0.00-1.70) excluding those with medication overuse and 1.75% (0.62-2.89) when adolescents with medication overuse were included. The majority of adolescents with CM had Headache Impact Test scores greater than or equal to 60, indicating severe headache impact, and mean Pediatric Migraine Disability Assessment scores greater than 17, indicating severe headache and disability. The majority of adolescents with CM (approximately 60%) had not visited a healthcare provider in the previous year and less than one in 5 reported taking medications to prevent headaches during the last month.Conclusions.-Results suggest that CM occurs less frequently in adolescents than adults, but like adults, adolescents are severely burdened by the disorder. Data support an unmet medical need; however, the development of optimal criteria for diagnosing adolescents with CM is critical to fully understanding how medical needs can be met within this complex population.