A recent study on burden of headache disorder in adults aged between 18 and 65 years by NIMHANS suggests that women are more susceptible to experience headache than men. Women are twice at risk of a headache than men and thrice at risk of reporting migraine.
The reason for this could be biological, chemical, hormonal, psychological or social causes, believes Dr G Gururaj, head of Department of Epidemiology, who headed the team that conducted the study.
Types of headache
Among different types of headaches, 26 per cent of people suffered from migraine, while 35 per cent reported tension type or stress-related headache disorders. This indicated that one out of three people had tension-type headache. Also, migraine attacks were more in people aged between 31-35 years and 41-45 years. Contrary to the general impression, the burden of headache was more in rural areas with the rural-urban divide gradually shrinking.
About 65 per cent of the people, who were interviewed, had headache for the last one year. Ten per cent had headache the day before the interview and three per cent of the people had chronic daily headache, with some having been on self-medication for as long as five years. A small proportion — 1.2 per cent — also reported headache induced by overuse of medication.
“Chronic, bothersome headaches are a major public health concern. While headache disorders are common, they are often neglected, thereby impacting the person’s quality of life,” said Dr Gururaj. This was indicated in the study, where among the people who suffer from chronic daily headaches, for 36 per cent it lasts for over eight hours, with another 36 per cent having it for four hours, and the rest suffering the headaches for four to eight hours.
The study also highlighted how only a fourth of the people sought help by visiting a doctor. Over 75 per cent indulged in self-medication, which was a dangerous practice, Dr Gururaj felt.
“People are spending more on managing headache disorders on their own and buying unwanted medication,” he said. He added that by continuously managing recurring headaches by themselves, it would only make them chronic thereby needing varying intervention.
“Depending on the precipitating and trigger factors, pharmacological and non-pharmacological interventions need to be devised,” he said.
Interestingly, a majority of the neuro epidemiological studies in India have indicated headache to be the first or second cause of morbidity followed by other morbidities like stroke, epilepsy, etc.
The study recommended identification of causes of headaches and early, proper and correct management of people with chronic and bothersome headaches. Apart from this, doctors and paramedical staff should be trained to recognise headaches at the right time. Public awareness should be created to seek medical management of headaches and avoid self-medication.
About the study
The study, which is the first population-based study on prevalence of headache disorders in India, was carried out in a population of 12,250 people from Bangalore Urban and Rural districts between April and December 2010. It was supported by Lifting the Burden: a Global Campaign to Reduce the Burden of Headache (a collaboration of WHO, World Headache Alliance, International Headache Society and Europe Headache Federation).